Rick
If you'll forgive me for not offering treatment options. The symptoms,
whilst not classic may be a chronic anterior compartment syndrome where
conservative treatment options can only hope to alleviate temporarily. Go
for intracompartmental pressure measurements and, if positive, fasciotomy.
Regards,
Michael
-----Original Message-----
From: [log in to unmask] <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: Sunday, August 29, 1999 2:16 PM
Subject: Heresone
>OK, heres one I could use help on.
>
>42 y.o male, very active with soccer, skiing, etc. Works as a surgeon,
>so is standing/walking quite a bit. Complains of ant. tib. pain x 2yrs
>mostly following orthotics he got from a Podiatrist because he noted that
>he supinated when walking. He work those orthotics x 6months then
>got new ones made by a Kinesiologist. He has attempted chiro., massage,
>kinesiology. No attempts with injections or PT. Brief curbside exam
>reveals usual tenderness in ant. tib. central, some tenderness in peroneus
L.,
>stretching with forced P flexion. Problem is that he did not feel ant. tib
>pain
>until the use of the original orthotics and now cannot get relief.
>He is no longer wearing any orthotics and found some cheap shoes to
>wear in O.R. but still gets pain even walking to his office not to mention
>playing ball.
>I am thinking of the obvious; Stretch, STM/TPP and Iontophoresis or do we
>go the dractic route and attempt night splints?
>OK, I'm all yours.
>
>Rick
>
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|