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Os navicularis syndrome vs Post Tib tendon dysfunction

Discussion in 'Pediatrics' started by Bug, May 18, 2005.

  1. Bug

    Bug Well-Known Member


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    Can anyone give me a DD for these.

    Have an 11 year old with Os nav present, unilateral pronation, is able to single leg raise....just and heel does invert. Is pain on palo the nav and PT insertions.

    What is the difference between these 2?

    Have so far been immolibising where possible, have orthoses with padding arround the nav area with a horseshoe, using NSAIDs and just referred to physio for managment of the PT stregthen etc.

    Anything else??? :confused:
     
  2. admin

    admin Administrator Staff Member

    Does the post tib tendon stay behind the medial maleolus or come out?
     
  3. Bug

    Bug Well-Known Member

    Stays behind but is prominent.....
     
  4. summer

    summer Active Member

    PT dysfuntion

    Several surgical approaches are considered when we see these patients who fail orthotic therapy. Subtalar arthroeresis is possible, and is viable in young children. They are reversable and have pretty good success with minimal invasivness. Couple this with a Kidner and possible TAL, and you should do well.
    IF the child is a bit on the larger side, and does partake in high contact activity, this may be ill advised.

    At that point, I would continue with conservative care, and after the epiphyseal plates have closed, consider the double calcaneal osteotomy consisting of calcaneal slide coupled with an Evans procedure, then add the Kidner and TAL. This is a permanent long term solution, but would reserve it until the child is nearly fully developed ontologically. Heel inversion on toe raise is an excellent sign. You might consider taking some Ischerwood x-ray views to see what the relationship of the calcaneus to the long axis of the tibia is.
     
  5. Craig Payne

    Craig Payne Moderator

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