Patient: 29 years old and was very active before accident.
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Hx: mountain biking accident 12/12 ago caused AJ and distal fibula #. Steel plate inserted into distal fibula. Pt contracted osteomyelitis shortly after Sx and remained in hospital for 5/12 on IV antibiotics. 3/12 on oral antibiotics. Patient began receiving physio joint manipulation therapy 4/12 ago.
Currently Pt has nil DF at AJ and has regained approx. 10 degrees PF through joint mobilisation. Minimal abd. or add. present. In gait, he has minimal heel strike with majority of WB in forefoot and contralateral limb.
QUESTION: Joint mobilisation from physio is excruciating for this Pt but has been the only thing providing him with greater ROM. Is there anything I can do to increase his AJ ROM with conservative therapy? orthotics? a night splint? What do the gurus think?
Cheers, Podski1
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