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Hi everyone,

A recent patient attended with pain in the R foot

• middle aged male with work requiring long periods of walking
• shoeware - light boots, laceup
• pain has increased since breaking leg 6 months ago - main pain appears to be Plantarfascia related
• leg was broken (in the same place) as a child, resulting in a malaligned distal tibia
• in stance R foot is cavus L foot neutral
• LLD examination showed R leg to be shorter (how accurate can the tests be?) & pt told me he thought this leg to be short his whole life (I measured and then got him to tell me which he thought was shorter)
• Hips appear neurtal

I will get a photo of the Right leg next visit but there is a definite break sight (about 5cm above the malleoli, where the tibia is externally rotated distal to that point.

Treatment has been about addressing the LLD and trying to get some symmetry between L & R foot, i feel a lot of his pain is related to rigid cavus foot type. Would anyone be referring him for Sx consult? I just feel its going to be very limited resolution to the out toe of the R foot due to an obvious osseous pathology.

 

Some copies of the xray might be good with the photos you might get some more advice about surg consult or not.