Content area
Full Text
Description
A 47-year-old white woman presented to the podiatry clinic with congenital bilateral residual talipes equinovarus (TEV). The condition progressively worsened as her job requires her to stand for extended periods of time. The patient states that she has increased symptoms of pain in her hallux of the right foot as well as generalised foot pain bilaterally. The patient recalls having corrective surgery as a child. She was offered further surgical correction during adulthood but declined. The patient takes no medication and has no systemic conditions. There is no family history of TEV. The patient admits to being born prematurely. Vascular and neurological examinations were unremarkable. Clinical observation ( video 1 ), radiographs ( figures 1 and 2 ), plantar pressure analysis (F-Scan; video 2 ) and a gait examination ( video 3 ) were performed. Significant findings were residual TEV bilaterally, a dorsal bunion and rigidly contracted hallux on the right. Orthopaedics dispensed bilateral accommodative shoe inserts made from 1/4'' white plastazote and 1/16'' pink plastazote and bilateral below-inlay heel lifts made from 1/4'' felt were provided to the patient. The patient relayed immediate improvement of symptoms on ambulation. The patient was further informed that controlling the first ray will be difficult, and eventual surgical intervention may be needed.
TEV occurs in approximately 1/1000 live-births, with bilateral deformities in approximately 50%. 1 Failure of treatment is the main aetiology of residual TEV. 1 Recognition of...