[ORT-L] new case ankle deformity


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[ORT-L] new case ankle deformity

emalpgi at gmail
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Jan 13, 2009, 4:11 AM

Post #1 of 7 (27215 views)
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[ORT-L] new case ankle deformity	Can't Post

hello there
i have a patient 17 years of age, with post traumatic ankle joint
dislocation , he has walked with dislocation for 6 years now and has
this deformity,, can some body suggest what would be the appropriate
name to describe it, and treatment options

May Almighty bless us all

Dr Emal Wardak
MBBS "SMS, Jaipur"
MS "Ortho" {Bronze medalist} PGI Chd, India, Dip. SICOT
Member of NZIOA,IAA "India"
AADO "Hong Kong", SICOT
Orthopaedic Surgeon
Kabul
0093-707034241
www.mussawardak-hospital.com

--
May Almighty bless us all

Dr Emal Wardak
MBBS "SMS, Jaipur"
MS "Ortho" {Bronze medalist} PGI Chd, India, Dip. SICOT
Member of NZIOA,IAA "India"
AADO "Hong Kong", SICOT
Orthopaedic Surgeon
Kabul
0093-707034241
www.mussawardak-hospital.com

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ti.george at gmail
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Jan 13, 2009, 7:20 AM

Post #2 of 7 (27215 views)
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Re: [ORT-L] new case ankle deformity [In reply to]	Can't Post

Dr Emal,
Are you sure it is a post traumatic problem or are there any clinical signs
of any neurologic problems? Any evidence to say that it could be a
neuropathic problem?

In any case this young person has walked on it during the growing stage
which has brought in changes. What are the clinical problems? Pain,
instability, shortening, cosmetic problems etc? We have to be sure that we
are not going to restore normalcy but are going to do a salvage procedure
which may address his clinical problems. So it is important to know the
clinical problems and patient's expectations to plan salvage procedure so
that the treatment can address patient's demands and not radiological and
clinical pictures.

On Tue, Jan 13, 2009 at 4:11 PM, emal wardak <emalpgi@gmail.com> wrote:

> hello there
> i have a patient 17 years of age, with post traumatic ankle joint

Dr. T. I. George,
(Dr George T Ittoop),
Sr Specialist, Orthopaedics,
Ibra Regional Hospital,
PO Box no: 3,
Postal code 413.
North Sharquia Region,
Sultanate of Oman.
Cell phone no: 968 95825197
Land phone no: 968 25587087

bsangeor at u
New User

Jan 13, 2009, 8:58 AM

Post #3 of 7 (27215 views)
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Re: [ORT-L] new case ankle deformity [In reply to]	Can't Post

Do you have xrays of the ankle? a CT?
----- Original Message -----
From: "emal wardak" <emalpgi@gmail.com>
To: <ORT-L@www2.aaos.org>
Sent: Tuesday, January 13, 2009 4:11 AM
Subject: [ORT-L] new case ankle deformity

> hello there
> i have a patient 17 years of age, with post traumatic ankle joint
> dislocation , he has walked with dislocation for 6 years now and has
> this deformity,, can some body suggest what would be the appropriate
> name to describe it, and treatment options
>
>
> May Almighty bless us all
>
> Dr Emal Wardak
> MBBS "SMS, Jaipur"
> MS "Ortho" {Bronze medalist} PGI Chd, India, Dip. SICOT
> Member of NZIOA,IAA "India"
> AADO "Hong Kong", SICOT
> Orthopaedic Surgeon
> Kabul
> 0093-707034241
> www.mussawardak-hospital.com
>
>
>
> --
> May Almighty bless us all
>
> Dr Emal Wardak
> MBBS "SMS, Jaipur"
> MS "Ortho" {Bronze medalist} PGI Chd, India, Dip. SICOT
> Member of NZIOA,IAA "India"
> AADO "Hong Kong", SICOT
> Orthopaedic Surgeon
> Kabul
> 0093-707034241
> www.mussawardak-hospital.com
>
---
[This E-mail scanned for viruses by Declude Virus]

alex61 at gmail
New User

Jan 13, 2009, 9:01 AM

Post #4 of 7 (27215 views)
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Re: [ORT-L] new case ankle deformity [In reply to]	Can't Post

Dear Emal

2009/1/13 emal wardak <emalpgi@gmail.com>:

> i have a patient 17 years of age, with post traumatic ankle joint
> dislocation , he has walked with dislocation for 6 years now and has
> this deformity,, can some body suggest what would be the appropriate
> name to describe it, and treatment options

Looks like neglected subtalar foot dislocation. AP view of the ankle will help.
Good case for the tibia-foot frame and gradual reduction. Will forward
the case to the russian ortho list,

--
Best regards,
Alexander N. Chelnokov
Ural Scientific Research Institute
of Traumatology and Orthopaedics
7, Bankovsky str. Ekaterinburg 620014 Russia
---
[This E-mail scanned for viruses by Declude Virus]

emalpgi at gmail
New User

Jan 13, 2009, 6:41 PM

Post #5 of 7 (27215 views)
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Re: [ORT-L] new case ankle deformity [In reply to]	Can't Post

Dear Dr. George.
yes its 100% post traumatic, there is no neurologic deficit, or any
sign of weakness, or infection,, the history as father tells, the guy
had felt from horse and then he was taken to local bone setter at that
time, and the ankle was fixed for onemonth, after they opened they saw
the foot was facing out side, and the guy started to walk on it,,
without any pain,,
they have come from village for two reasons, one cosmetic second he is
having slight limping due to around 2cm of true shotening but no
pain,.

On Tue, Jan 13, 2009 at 7:50 PM, T.I. George <ti.george@gmail.com> wrote:
> Dr Emal,
> Are you sure it is a post traumatic problem or are there any clinical signs
> of any neurologic problems? Any evidence to say that it could be a
> neuropathic problem?
> In any case this young person has walked on it during the growing stage
> which has brought in changes. What are the clinical problems? Pain,
> instability, shortening, cosmetic problems etc? We have to be sure that we
> are not going to restore normalcy but are going to do a salvage procedure
> which may address his clinical problems. So it is important to know the
> clinical problems and patient's expectations to plan salvage procedure so
> that the treatment can address patient's demands and not radiological and
> clinical pictures.
>
> On Tue, Jan 13, 2009 at 4:11 PM, emal wardak <emalpgi@gmail.com> wrote:
>>
>> hello there
>> i have a patient 17 years of age, with post traumatic ankle joint
>
>
> Dr. T. I. George,
> (Dr George T Ittoop),
> Sr Specialist, Orthopaedics,
> Ibra Regional Hospital,
> PO Box no: 3,
> Postal code 413.
> North Sharquia Region,
> Sultanate of Oman.
> Cell phone no: 968 95825197
> Land phone no: 968 25587087
>
>
>

--
May Almighty bless us all

Dr Emal Wardak
MBBS "SMS, Jaipur"
MS "Ortho" {Bronze medalist} PGI Chd, India, Dip. SICOT
Member of NZIOA,IAA "India"
AADO "Hong Kong", SICOT
Orthopaedic Surgeon
Kabul
0093-707034241
www.mussawardak-hospital.com
---
[This E-mail scanned for viruses by Declude Virus]

emalpgi at gmail
New User

Jan 13, 2009, 6:43 PM

Post #6 of 7 (27215 views)
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Re: [ORT-L] new case ankle deformity [In reply to]	Can't Post

will get and send it to u

On Tue, Jan 13, 2009 at 9:31 PM, Alexander Chelnokov <alex61@gmail.com> wrote:
> Dear Emal
>
> 2009/1/13 emal wardak <emalpgi@gmail.com>:
>
>> i have a patient 17 years of age, with post traumatic ankle joint
>> dislocation , he has walked with dislocation for 6 years now and has
>> this deformity,, can some body suggest what would be the appropriate
>> name to describe it, and treatment options
>
> Looks like neglected subtalar foot dislocation. AP view of the ankle will help.
> Good case for the tibia-foot frame and gradual reduction. Will forward
> the case to the russian ortho list,
>
> --
> Best regards,
> Alexander N. Chelnokov
> Ural Scientific Research Institute
> of Traumatology and Orthopaedics
> 7, Bankovsky str. Ekaterinburg 620014 Russia
> ---
> [This E-mail scanned for viruses by Declude Virus]
>
>

--
May Almighty bless us all

Dr Emal Wardak
MBBS "SMS, Jaipur"
MS "Ortho" {Bronze medalist} PGI Chd, India, Dip. SICOT
Member of NZIOA,IAA "India"
AADO "Hong Kong", SICOT
Orthopaedic Surgeon
Kabul
0093-707034241
www.mussawardak-hospital.com
---
[This E-mail scanned for viruses by Declude Virus]

ti.george at gmail
New User

Jan 14, 2009, 10:46 AM

Post #7 of 7 (27211 views)
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Re: [ORT-L] new case ankle deformity [In reply to]	Can't Post

Dr Emal,
Thanks for the info.

My impression is that whatever procedure we undertake will be of salvage
nature. Options according to me are:
1) Acute correction with further shortening and arthrodesis of the affected
joints, (You can consider a lengthening at some stage)
2) Gradual correction with a frame and lengthening along with arthrodesis.

The questions are, will these address patient's problems?
1) Cosmetic appearence - yes but it may not look absolutely normal.
2) Limping - may not address fully.
3) Shortening - can be addressed but some shortening may be desirable in
view of the requirement for arthrodesis.

Now you have to face the big question. Do the patient and his relative
understand all these and are they prepared for the expected result at the
end of treatment? ( From what you say they come from a village background
and may not comprehend the full problems).

Do keep us informed on what is done and the follow up. Good case for
academic discussion but difficult one to tackle.

Best of luck.

Dr. T. I. George,
(Dr George T Ittoop)
Sr Specialist, Orthopaedics,
Ibra Regional Hospital,
PO Box no: 3,
Postal code 413.
North Sharquia Region,
Sultanate of Oman.
Cell phone no: 968 95825197
Land phone no: 968 25587087

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