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A surgical case?

Discussion in 'Foot Surgery' started by Kahuna, Aug 6, 2009.

  1. Kahuna

    Kahuna Active Member


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    A question to the surgeons please...

    I have a young male patient (32 years old) who has presented wanting to know what his podiatric condition is...

    He has no ankle equinus, but he has no ability to move either foot medially, even when standing on tiptoe whilst medially rotating the tibia.

    He has been to numerous orthopaedic surgeons who haven't provided a diagnosis or treatment plan, although they've found his limited ankle mortice ROM of interest.

    He has no symptomatic pain, but is frustrated at the limitations of his rearfoot mechanics, especially as he finds it impacts on his skill/ability when playing football.

    Thanks
     
  2. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    kahuna

    You have given no information of your own assessment and findings...

    If you could provide some basic orthopaedic examination findings you will be more likely to get some sensible opinions. Even better, provide at least copies of weight-bearing AP, lat and MO films of the foot and ankle +/- Harris & Beath views.

    Given the scant details, have you excluded a middle facet subtalar joint or calcaneo-navicular coalition? This would generally be the most obvious cause of ROM limitation in the hindfoot.

    LL
     
  3. drsarbes

    drsarbes Well-Known Member

    I'm with LL.
    "no ability to move either foot medially" is of no value.

    One point though, any sub talar coalition is not that difficult to diagnose. I can't imagine "numerous" orthopedic surgeons missing this pathology. Perhaps something more occult (read - interesting!)

    Steve
     
  4. Kahuna

    Kahuna Active Member

    OK thanks for replies - I'll ask pt for appropriate XR
     
  5. drsarbes

    drsarbes Well-Known Member

    "OK thanks for replies - I'll ask pt for appropriate XR"

    That's not what will help us help you.
    How about a complete history and an examination (ortho exam, gait analysis, etc....) post the results and we can perhaps digest the data and see what we come up with.

    Steve
     
  6. tonyw

    tonyw Member

    Sounds like a coalition

    Tony wilkinson
     
  7. nlortizdpm

    nlortizdpm Member

    I agree with Steve and LL. Please provide us with more information.
     
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