Case of the Week 8-9-06: What people said...

Hi Chris,
On his left foot does he have any toes missing? from the video clip of him barefoot in the living room it looks as if he is missing his 2nd toe.
You mention the majority of the problems are on his Left foot yet you also mention that he wears the AFO on his right foot is there a problem with the right that he requires this, and not on the left Heel Cups and AFO's will do nothing to help this young guy! basically due to his over pronation in both feet he requires custom made rigid bilateral Medial arch supports. This will prevent him from pronating too much and stop this characteristic deformation of his footwear which is commonly seen in patients with flat feet.
Another question; what is the range of motion at his ankle joint is it in an equinos position as this may need some alterations to the orthotics slightly. By the sounds of it I suggest he has limited RoM at his ankles due to his inability to get sufficient ground clearance. Does he have Talipes equino varus which is a common manifestation in twins.
It is very difficiult to analyse his gait from the video feeds given but they arent really important. If he has the correct orthotics they can also correct the intoeing gait.
if you could get me some more info regarding this it might be useful thanks
Rob Menzies Podiatrist Hamad Medical Corporation Doha Qatar

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