ankle challenge

ankle challenge

Heather Davidson

1/7/2002

I am working with a patient who is in her 70's, has had both knees replaced
(right in October 2001) & a history of severe pronation - right more than
left.

During our first meeting, she showed me the many styles of foot orthosis she
has tried, an air cast ankle stirrup & a couple of other ankle supports -
all to little or no avail.

I have tried to fit her with a custom made SMO. Althouh she complains of
sever pain, there is no clear redness indicating the location. After
various combinations of materials (including silipos gel), adjustments,
posting & trimmming I am close to surrender ...... she wants something that
corrects her foot - hindfoot valgus, midfoot pronation & forefoot abduction
which in turn puts a valgus strain on the recently replaced knee - but does
not cause pain ! (There is no trouble at the proximal edge & the device
fully controls the foot/ankle - hindfoot is vertical & there is no forefoot
abduction = what i thought was a great result !)

Her idea is to stick aircast cells inside the SMO - not practical !

The obvious idea - to try a device with a higher trim - was discussed. I'm
usually easily convinced that extending the lever arms higher would work,
but not in this case. I really think she cannot tolerate any pressure
anywhere along the medail aspect of that foot.

Is anyone aware of a device that incorporates an aircast like buffer &
offers GOOD tri-planar control of the foot/ankle ? I said i'd ask !!!!!

THANKS IN ADVANCE - Heather



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