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Hi. I have one interesting/a bit challenging case.
78 yrs old patient with midfoot break (unilateral) and compensatory extensor/flexor muscle imbalance, leading to lesser MTPJs subluxation.
Surgeon sent referral letter to me to make foot orthoses - functional and accommodative orthoses which off-load lesser MTPJs whilst provide support calcaneal/cuboid area to stabilise R/mid-foot
The patient has wide feet and wants to have prefabricated or semi-customised orthoses (precast) for financial issues
A bit trouble for me to select mid-foot device vs rear-foot device and orthotic shell materials such as polypropylene vs EVA. His rearfoot - slightly valgus and medial arches were collapsed
Any suggestion and/or advice would be appreciated
Thank you
Kind regards

 

What actually hurts?

 

Patient said forefeet - over lesser MTPJs. Fibrofatty padding over plantar MTPJs was diminished