Hi all,
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I was hoping for some advice on a interesting case
Male patient, 64 years old. Healthy, only taking Lipitor
PRESENTING COMPLAINT
Many months of on again off again pain in the left foot
1: Lateral aspect of Inf Extensor retinaculum. This is mild
2: When rearfoot is fixed and midfoot/forefoot everted. This is severe and at its worst when walking on uneven ground
BIO
Pes planus
STJ / MTJs restricted
Tib Post weak compared to right side, other muscles showed good strength
Equinus (gastro and soleal)
Supinatus
RSCP 10 deg NCSP 0 (right side is 8 and 0)
Medially deviated STJ
Very very high SRT
Functioning at the end ROM (minimal pronation possible when standing in RSCP)
Abducted gait
The severe pain the patient reported was concerning me so I asked him to get an MRI. The results indicated advanced tib post dysfunction with secondary sinus tarsi syndrome. It also mentioned that there was degeneration of the deltoid, spring and bifurcate ligaments.
I am interested to know if this man would benefit from an injection into the sinus tarsi, and if I should be seeking a surgical opinion. He has been wearing what looks like a pair of modroots since 2004 that are not giving him the control he needs so I was planning on an inverted device made from rigid polyprop, a medial skive of 8mm, high heel cup and a rearfoot post. Am I missing anything?
Thanks
Eliza
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