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Hello, I am new to this and so here I go with my first thread...

I have a patient, 42 M, who presented with a history of bilateral forefoot pain with an area of local pain under the head of each 5th met. No history of direct trauma.

Non-weightbearing examination revealed good quality ROM of 1st MTPJ, STJ and ankle joints (both feet). Tailor's bunion is evident on both feet, the right showing more deviation than the left. 5th ray/met of both feet appear to be in a plantarflexed position. The 5th digit seems to be in an adducto digiti varus. This and the plantaflexed position of the 5th met is a contributory factor of higher forces/loading occurring under the 5th met which probably explains the fibrous corns under each 5th met head.

On standing, both heels are moderately inverted and the MLA are well maintained

As my case study I need to come up with 2 prescriptions for orthotics, one being practical and cost effective, the second based on the optimal scenario in an 'ideal' world

I have a few ideas but just wanted to see what everyone else thought and I would love to hear some suggestions :)

Thanks!

 

:welcome:

A good place to start would be these threads:
Can a plantarflexed 5th be misdiagnosed as a forefoot varus?
Posting for forefoot varus
Uncompensated Forefoot Varus
Uncompensated forefoot varus - what do I prescribe?

 

Valoraste a surgical procedure to your patient?

 

There is more than one foot type that will have a high load sub 5th met head. The information that you have given is not enough to differentiate between the two. If the patient was standing and asked to evert their foot, is there range of motion of the foot to move in the direction of eversion. There was a recent thread where this was discussed, but I couldn't find it with a quick look.

Eric