Hi all
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Today I have seen a 15 year old girl with a history of recurrent 3rd digit dislocation/ subluxation (this is subjective) in both feet. Her mother has said this has been ongoing for just over 2 years with one of the 3rd toes on either foot dislocating approximately every 3 months. The young girl can tell when it is going to happen as she gets a pain on the dorsum of the foot (in the area of the MTPJs) as well as anterior ankle pain and then if she is moving the foot at all or walking the toe will dislocate. This has even occurred while putting on shoes. Following this, the toe puts itself back in position and while there is some pain following it doesnt really affect function.
Does anyone have any ideas / suggestions on cause or areas to look at? I have not come across this before.
Hypermobile foot joints
Medially deviated STJ axis
Clawing digits as well as "crooked" toes medially and laterally
stage 1 HAV bilaterally
Pain she describes prior to dislocation seems to be EDL, however muscle testing all seems within normal ranges
Her previous podiatrist has done manipulation, however this does not prevent re-dislocation. Also considering possibility of previous bilateral freiberg's of 3rd which may have caused instability at this joint. At this stage, I am open to any ideas?
Thanks in advance!
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