Case study for genu valgum
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Collection
Title:
Case study for genu valgum
Text:
DX: rheumatoid arthritis/systemic lupus for 30 years... Female patient is
64 y/o, 118 lbs, 55. She is s/p right hemi hip arthroplasty, 9 days
post-op. Medication is 4 MG's prednisone daily. She is currently wearing a
solid right afo for a semi-fixed IRD/DJD at the foot and ankle with fixed
calcaneal valgus of 5 degrees, and a mod.-severe abducted forefoot. Her left
LE has 5 degrees of genu-valgum and uninvolved.
I saw the patient, Jean, in PT. walking with a gait belt 25 feet at a time
and doing well for 9 days post-op. She has a positive attitude, good
strength considering her history, and will be able to doff/donn the orthosis
independently. She lives with her husband and realisticly will be a
household/mild community ambulator. She states she is retired from a dental
office, regretfully so.
The teams concern is a right flexible genu-valgum of 5-13 degrees open
chain, which compensates to 16 degrees closed chain. The knee is
asymptomatic. ROM is 0-0-130. The concern is that the femoral adduction will
compromise the results of the HHA. Surgery has weakened her gluteus medius
and not helped the situation.
My orthotic concern is dealing with no medial knee clearance in swing phase.
Also weight is a concern so as not to distract the hip in swing. Jean's right
LE is moderately swollen post-op and this will be monitored next week and as
needed for design ideas and probable casting.
Please mail me with orthotic treatment ideas. I will submit these once
received. I am thinking along the lines of a check orthosis, and a
laminated lateral bar kafo with extended, padded medial trimlines. Also, a
molded padded insole and medial shoe buttress will help the base of support.
This I believe will give me frontal and axial plane strength with just one
bar. My past experience with a steel bar and poly shells have been mixed.
Thank you for your input in advance,
Bruce Russell CO
64 y/o, 118 lbs, 55. She is s/p right hemi hip arthroplasty, 9 days
post-op. Medication is 4 MG's prednisone daily. She is currently wearing a
solid right afo for a semi-fixed IRD/DJD at the foot and ankle with fixed
calcaneal valgus of 5 degrees, and a mod.-severe abducted forefoot. Her left
LE has 5 degrees of genu-valgum and uninvolved.
I saw the patient, Jean, in PT. walking with a gait belt 25 feet at a time
and doing well for 9 days post-op. She has a positive attitude, good
strength considering her history, and will be able to doff/donn the orthosis
independently. She lives with her husband and realisticly will be a
household/mild community ambulator. She states she is retired from a dental
office, regretfully so.
The teams concern is a right flexible genu-valgum of 5-13 degrees open
chain, which compensates to 16 degrees closed chain. The knee is
asymptomatic. ROM is 0-0-130. The concern is that the femoral adduction will
compromise the results of the HHA. Surgery has weakened her gluteus medius
and not helped the situation.
My orthotic concern is dealing with no medial knee clearance in swing phase.
Also weight is a concern so as not to distract the hip in swing. Jean's right
LE is moderately swollen post-op and this will be monitored next week and as
needed for design ideas and probable casting.
Please mail me with orthotic treatment ideas. I will submit these once
received. I am thinking along the lines of a check orthosis, and a
laminated lateral bar kafo with extended, padded medial trimlines. Also, a
molded padded insole and medial shoe buttress will help the base of support.
This I believe will give me frontal and axial plane strength with just one
bar. My past experience with a steel bar and poly shells have been mixed.
Thank you for your input in advance,
Bruce Russell CO
Citation
“Case study for genu valgum,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/212466.
