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Hi Again.

I have a neuropathic diabetic Pt who also has Dupytrens contracture (he used to be a Viking apparently) and (L) pitting oedema Venous?.

Anyhoo a while back he inversion sprained his ankle (L) and has recently noticed he is putting more weight on his 5th styloid and 5th met laterally (more then before the sprain) x rays didnt show anything (these were non Weight Bearing by the Physio). His foot is noticably more inverted then previous visits (for now healed 5th met plantar ulcer). The foot is still flexible and can be pronated to a normal looking position.

I have given him a moon boot and offloading padding to reduce WB, however with his Oedema and ensuing warmth to the (L) foot it is hard to make the call.

I am wondering where to go next? An Orthopod review and possible casting to straighten the foot? or should I keep the moon boot going until the warmth / swelling goes down (if it does) and see what happens.

Thanx for advice


Joe wheeler