Hi Everyone,
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I have been very thankful for all the information contributed by all in the forum, and would appreciate any thoughts on my current case.
Male patient with a 8 month history of a recurring ulcer on his 5th MPJ. The site has healed but orthotics have been prescribed with aims to offload the site. He stands 8+ hours a day in mining boots.
Significant clinical findings in the assessment includes:
- restricted right rearfoot eversion ROM available during NWB exam
- hypermobile 1st ray/reduced 1st MPJ stiffness when the right foot is loaded in NWB
- low supination resistance of right foot compared to left
- gait analysis shows excessive right foot supination during heel contact, midstance and at propulsion (so low-gear propulsion off the right 5th at propulsion).
My initial plan with an orthotic device with:
1. 0 degrees rearfoot posting
(wouldn't a lateral wedge cause more irritation due to the restricted rearfoot eversion available?)
2. 4-6mm EVA lateral arch support from styloid process of 5th to base of 5th MPJ
3. forefoot - 1st to 4th MPJ with eva to accommodate the 5th?
4. topcover - 3mm poron/cambrelle for additional cushioning
What other strategies could be employed to offload the 5th MPJ?
It's all from the top of my head but i will try to update with more clinical details asap! Thanks all for your time :)
<
Perroneus brevis tendonitis + pes planus
|
Help with our bachelor assignment - choosing a running shoe from 3 different test's
>
<
Perroneus brevis tendonitis + pes planus
|
Help with our bachelor assignment - choosing a running shoe from 3 different test's
>
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