Rick:
A bit more information would be helpful. Any other exam findings beside pain to
palp.? Does he actually supinate or ha other abnormal mechanics? How soon after
walking does his pain come on?
Michael Warburton wrote:
> 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
> >
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