Hi all,
Members do not see these Ads. Sign Up.
I would appreciate help on a patient who came into our clinic recently
34 year old healthy female diagnosed with avascular necrosis of navicular 2008.
Surgical consult at the time recommended talonavicular arthodesis. Patient didn't go through with surgery as she had small children, at this stage started walking in a compensatory style to avoid pain.
Weightbearing now is on lateral side of foot - patient has created a significant supinated foot type with prominent 5th MTPJ, styloid process and her 5th toe is now sitting dorsally.
She has no pain in navicular area anymore - chronic pain on lateral ankle - limited STJ ROM (very little, if any, eversion and limited inversion), AJ ROM restricted. She is walking with a pronounced limp and is in chronic pain.
Recent Xray showed no evidence to support the prior diagnosis of AVN of the navicular (which itself maintains normal volume and overall appearance), rather there is marked OA of the talonavicular joint. There is a degree of subluxation of the TN joint with the naviuclar slightly medially subluxed relative to the talus.
Pt still doesn't want surgery at this stage.
What would people recommend as the best alternative treatment to allow the patient to function in her normal daily life?
Thanks in advance
Tags:
Loading...
- Similar Threads - female joint
-
- Replies:
- 3
- Views:
- 657
-
- Replies:
- 1
- Views:
- 933
-
- Replies:
- 1
- Views:
- 802
-
- Replies:
- 0
- Views:
- 1,094
-
- Replies:
- 0
- Views:
- 1,274
-
- Replies:
- 2
- Views:
- 2,500
-
- Replies:
- 0
- Views:
- 1,036