HAV and FF Valgus Posting

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on the thread about FF Valgus posting and reduced PF strain http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=44298

I was asking if a FF valgus posting could lead to greater deformity of HAV if they have an HAV deformity to begin with.

So if we take this patient who has come to see you for Plantar fasciitis.

you have come to the conclusion of Excessive PF load. You decide on a medial skive with a FF Valgus post as the research says that this will reduce the load on the PF.

By including the FF Valgus post you will also be increasing the loads taken by the
1st MTP joint and this will as the heel rises lead to greater dosiflexion of the 1st MTP joint and the windlass effect.....

Now here is my question if this above patient has an HAV deformity will the treatment plan have the possibilty to increase the HAV angles at a faster rate than would have occured without the FF Valgus post.

From my reading I would say yes.

what do others think ? Is it something to consider in our patients with PF and HAV ?

EDIT Please note I´m not discussing treating HAV with these device, just can we make the deformity worse.

 

Why do you feel that the forefoot valgus post would increase the load on the 1st MPJ? In my windlass article I describe how tension in the fascia will tend to increase the medial deviation of the first met (Those Snijders articles). So decreasing tension in the fascia should slow HAV progression.

Regards,
Eric

 

Thanks for pulling me up before I ran away with my thoughts. I was thinking that the FHL, EHL would have different loads with the FF Valgus pad and if they had a lateral insertion points it would add to the deformity.

I´ll go re read your windlass paper again. If you ever come across those Snijders articles when you unpack I would love a copy to read.

Thanks again Eric.

 

hello, can someone tell me the name of the Fuller article, please? or even better, can someone post it here (pretty please!!)



Peter

 

Peter,

This is the puppy - a paper thats worth re-reading every few months in my opinion

Ian

 

Hi Ian,

I really appreciate it,

Peter