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Advice for case with PTTD post HAV surgery

Discussion in 'Biomechanics, Sports and Foot orthoses' started by admin, Jun 30, 2011.

  1. admin

    admin Administrator Staff Member


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    I have been asked for some help on this problem:

    Your input will be much appreciated.
     
  2. First thing which jumps out at me is
    They'll see a foot as flat only in static. They cannot see the windlass. If there is no ROM at the 1st MPJ the may have been some supination moment from windlass which they've now lost and the PT may be taking up the slack.
     
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  3. hunninblue

    hunninblue Welcome New Poster

    Thank you for you response, could you give me any advice on treatment options for this patient please? it would be greatfully received
     
  4. RobinP

    RobinP Well-Known Member

    Loss of balance. Aquired flat foot pre op. Questionable neurology?
     
  5. Admin2

    Admin2 Administrator Staff Member

  6. Trevor Prior

    Trevor Prior Active Member

    Are you able to provide pre and post op x-rays - AP and lateral weightbearing?

    There are a number of factors with a Lapidus that could cause a problem - for instance a short / dorsiflexed metatarsal.

    The biomechanical evaluation will help but this is a case where x-rays are a must.

    Also, 3 months post op is early days for a Lapidus, especially in a 75 year old patient.

    Trevor Prior
     
  7. efuller

    efuller MVP

    What does collapsing on the arch mean? It hurts to bear weight? Knowing what the problem is really helps.
    What anatomical structure of the Arch? Fascia? Bony? Muscle?

    Often PT dysfunction patients have a bunion. Certainly plausible.

    I wonder if there was any discussion on how the surgery would help the falling over problem?

    If there is a PT dysfunction a varus heel wedge should be helpful. Position of the STJ axis?
    More info needed.
     
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