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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

 

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

 

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

 

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

 

"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

 

Sounds like a coalition

Tony wilkinson

 

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