Hi Guys,
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Just need some help regarding an elderly female pt (over 60) no notable medical hx, only on pain medication:
S: Severe Pain and swelling in her Right ankle after falling and hyperplantarflexion over 2 years ago. She attended the hospital who performed x-rays and found nothing to be broken just soft tissue damage.
O: O/e pt has swelling all around the right ankle joint, pain is palpable on both medial and lateral ligaments, also pain on palpation of the right achilles tendon (probably due to swelling). pain is also felt on the anterior of the ankle joint.
She suffers pain on forced inversion and eversion of the foot, and plantar and dorsiflexion is uncomfortable
she has bilateral rearfoot varus of 3 degrees and a functional lld of approx 8mm (right longer)
P: Due to this lady's dispondance with other medical professions regarding her treatment she refuses to see anyone for a referral for further exploration, so I have set out this plan for her:-
short term - to try and reduce the level of swelling by use of ice therapy, and nsaids, and to try some temporary orthoses to see if this improves the condition.
longer term I think she would benefit from an AFO to provide further support to a very weakened ankle, which brings me to my question, can a podiatrist prescribe an AFO and if so how can I get hold of one.
kindest regards in advance for taking the time to read this (sorry it is long)
Steve
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