Members do not see these Ads. Sign Up.

Hi

A patient came to see me with pain in his left 2nd mpj. There is also pain in the 2nd right mpj, but not as great. Both hallux are approx. 2.5cm shorter than his 2nd toe. the other lesser toes graduate from the 2nd and look in a 'normal' pattern. the 1st mpj is approx. 1.5 cm proximal to the 2nd mpj. There were no other remarkable findings.

He is active, plays tennis and wears city shoes to work. there is no callus.

I made him a removable pad with an extension along the shaft of the 2nd. - the purpose was to reduce the movement at the 2nd mpj.

I looked at Morton's extension which refers to a pad along the shaft of the 1st - I did not think this was suitable, as it would deflect pressure to the 2nd. or does this add a rocker to the 1st mpj, improving it's function by moving the moment more distally?

I did mention surgery to lengthen the 1st, but the patient would prefer a conservative treatment at present.

I plan to issue an otc orthtotic with a modification, but would like any advice to the type of modification. obviously will incorporate his feedback from the device I have currently issued.

thanks flo