Colleagues
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This morning I examined a six-month-old girl with extremely restricted range of motion in right ankle joint – approximately 5-10 degrees. The foot is held in a neutral mid-stance position. Radiographic examination reveals no bony abnormality or malformation. Forced extension or flexion causes obvious distress. Birth was unremarkable except that the baby was in a breached position until two weeks prior to delivery then she righted herself. Normal delivery – no forceps or suction. The left ankle ROM is as one would expect in a six-month-old baby – more than adequate. No adverse family history. No neurological symptoms. No sensory loss.
My thoughts were that she may have had the ankle extended for a protracted period – perhaps against the womb wall – during pregnancy and this has caused contracture of the anterior muscle compartment and associated soft tissues. Is this feasible given six months have elapsed? Also, is there any other investigations/treatment that can be offered aside from gradual manipulation?
Thanks in anticipation
Mark Russell
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Static and dynamic foot characteristics in children aged 1-13 years
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Ontology- What is the first bone to reach external torsion first from the Femur, Tibia and Fibula?
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Static and dynamic foot characteristics in children aged 1-13 years
|
Ontology- What is the first bone to reach external torsion first from the Femur, Tibia and Fibula?
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