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Hi Docs

Posted by Pam B on 4/29/02 at 20:48 (081678)

I went to my appt today and the doc added a condition to the list.....calcaneal cuboid syndrome......can you tell me what that is exactly......I would have asked the pod but by the time I seen it in writing he was with another patient......after reading, I think it has to do with the PF surgery and overcompensation of the remaining part of the fascia.....but I still dont really understand it or how physical therapy will correct it? Can you offer me some of your expertise? Thanks for your time :)

Re: Hi Docs

Dr. Cozzarelli on 4/30/02 at 05:27 (081715)

Hi Pam:
When EPF'S were fisrt being being performed there was a complication if all ofthe fascial bands were cut. The foot actually would become unstable. It resulted in cuboid syndrome. The instrumentation was then modified to have a marker placed in the cannula so when the bands were being cut the lateral band was left intact. Anatomically there is a structure called the interseptal defect. This is also an anatomic marker where band are being cut. My adive is that if you havecuboid syndrome have your Doc put a cuboid pad on the orthotic. Sometimes this helps. This is why I never jump on band wagons initially. I waited about 2 years after the EPF was developed to see what the results were.

Dr. John Cozzarelli

Re: Didnt have EPF does it matter?

Pam B on 4/30/02 at 07:37 (081726)

Hi Doc C...first let me say thank you for explaining this to me, I always seem to have questions when I leave that I dont think to ask when I am there :).....I think I get it but I did not have EPF...I opted for the open procedure due to the failure rate of the EPF....my hope was to have this surgery one time only so I wanted them to see as much as possible....does the open procedure have any impact on the end result????

Re: Didnt have EPF does it matter?

Ed Davis, DPM on 4/30/02 at 15:15 (081817)

It is possible for EPF to miss some medial aspect of the the PF so there may be an advantage to the open procedure. The occurrence of cuboid syndrome after a plantar fascial release is probably independent of the type of release. In theory, leaving some of the lateral band of the plantar fascia intact, independent of technique used, can lower the incidence of cuboid syndrome. This theory has not been proven nor disproven. I tend to prefer to release the entire fascia and not really worry about cuboid syndrome. Cuboid syndrome, if it is going to occur, is something I am always on the lookout for and I will treat it early and aggressively if it appears. I feel that it is relatively easy to treat provided it does not go on too long.
Ed

Re: Thank you Dr's :)

Pam B on 4/30/02 at 17:44 (081838)

I am due to start Pt Dr Davis next week....my pod told me to treat my PT as a full time job and be as aggessive as possible to strengthen my ankle.....thank you for your input, I truely appreciate it.....:)

Re: Hi Docs

Dr. Cozzarelli on 4/30/02 at 05:27 (081715)

Hi Pam:
When EPF'S were fisrt being being performed there was a complication if all ofthe fascial bands were cut. The foot actually would become unstable. It resulted in cuboid syndrome. The instrumentation was then modified to have a marker placed in the cannula so when the bands were being cut the lateral band was left intact. Anatomically there is a structure called the interseptal defect. This is also an anatomic marker where band are being cut. My adive is that if you havecuboid syndrome have your Doc put a cuboid pad on the orthotic. Sometimes this helps. This is why I never jump on band wagons initially. I waited about 2 years after the EPF was developed to see what the results were.

Dr. John Cozzarelli

Re: Didnt have EPF does it matter?

Pam B on 4/30/02 at 07:37 (081726)

Hi Doc C...first let me say thank you for explaining this to me, I always seem to have questions when I leave that I dont think to ask when I am there :).....I think I get it but I did not have EPF...I opted for the open procedure due to the failure rate of the EPF....my hope was to have this surgery one time only so I wanted them to see as much as possible....does the open procedure have any impact on the end result????

Re: Didnt have EPF does it matter?

Ed Davis, DPM on 4/30/02 at 15:15 (081817)

It is possible for EPF to miss some medial aspect of the the PF so there may be an advantage to the open procedure. The occurrence of cuboid syndrome after a plantar fascial release is probably independent of the type of release. In theory, leaving some of the lateral band of the plantar fascia intact, independent of technique used, can lower the incidence of cuboid syndrome. This theory has not been proven nor disproven. I tend to prefer to release the entire fascia and not really worry about cuboid syndrome. Cuboid syndrome, if it is going to occur, is something I am always on the lookout for and I will treat it early and aggressively if it appears. I feel that it is relatively easy to treat provided it does not go on too long.
Ed

Re: Thank you Dr's :)

Pam B on 4/30/02 at 17:44 (081838)

I am due to start Pt Dr Davis next week....my pod told me to treat my PT as a full time job and be as aggessive as possible to strengthen my ankle.....thank you for your input, I truely appreciate it.....:)