Greetings all
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I hope to get some professional opinions regarding a case which presented here.
It is hard to cover all of this here, but briefly...
- 12 yo boy who had surgery in Germany for Talipes 10 years ago
- Has had pain only for the last 18 months after playing football. Now has symptomatic L first MTPJ.
- He has obvious limited STJ ROM with significant FF varus
- Both 1st MTPJ are grossly plantar flexed
- He cannot dorsiflex the L 1st and it appears the joint is subluxed plantarly and EHL may have translated laterally to the digit.
- Obviously he is mechnically a bit of a mess, and his concerns are pain and he cannot wear enclosed shoes (not such an issue in the Middle East as othe parts of the world...). Also worried about progression.
I expect this is a surgical case, but the question would be how far to go and how to proceed? Is this treated as a 1st MTPJ pathology or do we address all the alignment issues surgically also? Should this be done now or when he is older?
We have excellent surgeons here, but I suspect this may need specialist foot and ankle man...
I have attached xrays and can attach photos later.
Many thanks
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