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A few orthodic questions...

Posted by Jennifer on 9/29/02 at 13:31 (096432)

I had my left accessory navicular excised July 1st. I was cast for some orthodics last week and was wondering how long it takes to have those made... Also the PT who cast me said that the way my foot was making contact with the ground was soooooo off that I might have to go through an intermediate correction before going on to a final correction. How long does this process take ?????? There was also some question on deciding what material to make the orthodics out of...with my knee and hip issues he seemed to be leaning towards titanium, is that standard ??????

My OS did say that it would take a while for the bone to settle down as he did an osteotomy and then secured it with anchors. So I realize there won't be any quick fixes, as I have had tibial osteotomies on both legs.

I am having difficulty with the opposing knee since I had the excision. Is that typical ?????????

Thanks for all your help thus far : )

Jennifer

Re: A few orthodic questions...

Dr. Z on 9/29/02 at 18:49 (096474)

You are telling me that you had both of your legs broken ? At the same time? Why? I have never heard of a foot orthosis made of titanium. I am not trying to answer these questions with questions but you have a very atypical case.

A orthosis is made to correct abnormal motion and to maintance a neutral position of the foot during the various time during the gait cycle. In addition the length of your legs are a factor due to the cutting of the bones. In addition the function of the forefoot has to be taken into account.

I guess i can only be general without seeing and evaluating your feet and your gait.

Re: A few orthodic questions...

Jennifer on 9/29/02 at 20:27 (096484)

Yes....I have had both of my legs surgically broken (osteotomies). They were done one year apart: May 1999 and May 2000. I have maltracking patellae (ie. I had a long history of subluxation and dislocation of both patellae). The causes of this are multiple...I have trochlear displasia (flat on the medial side - bilateral), I have patellae alta, and my VMO attaches higher than it should.

My legs are generally the same length...the osteotomies did not alter my height.

I am having a lot of balance issues since having the accessory removed. If I lean over too far I start rocking back and forth on my feet and it is pretty disturbing. Some of that I attribute to the fact that I was only 3 months post-op on the opposing knees last surgery, but it seems to be more than that.

Gait is another area of concern for me. I feel as if I lose a step ever so often which makes being on a treadmill frankly dangerous. I tend to do all of my cardio on a stationary bike.

I have some other issues with my foot...my big toe curves inward and the OS has said that the joint connecting the big toe to my foot is nearly fused (as a result of arthritis ???). I also have bunionettes although they are not really symptomatic. The PT seemed to suggest that my foot didn't strike the ground appropriately in any way.

I think the PT was thinking out loud when he was talking about the orthodic being out of titanium...he must be thinking that I need something fairly light ????? Hard to tell...he did say that he didn't think there was anything that he could offer me in the way of PT that would help : ( He said that my knees were the worst that he had ever seen. The only ray of sunshine was that my right foot seems to be doing well (It still has it's accessory and it has only had one problem - avulsion fracture after the osteotomy in 2000. It healed very well).

So, yes...I do have some serious issues other than my feet and my medical history will be one for the books...

Thanks for your concern...

Jennifer

Re: A few orthodic questions...

Dr. Z on 9/29/02 at 18:49 (096474)

You are telling me that you had both of your legs broken ? At the same time? Why? I have never heard of a foot orthosis made of titanium. I am not trying to answer these questions with questions but you have a very atypical case.

A orthosis is made to correct abnormal motion and to maintance a neutral position of the foot during the various time during the gait cycle. In addition the length of your legs are a factor due to the cutting of the bones. In addition the function of the forefoot has to be taken into account.

I guess i can only be general without seeing and evaluating your feet and your gait.

Re: A few orthodic questions...

Jennifer on 9/29/02 at 20:27 (096484)

Yes....I have had both of my legs surgically broken (osteotomies). They were done one year apart: May 1999 and May 2000. I have maltracking patellae (ie. I had a long history of subluxation and dislocation of both patellae). The causes of this are multiple...I have trochlear displasia (flat on the medial side - bilateral), I have patellae alta, and my VMO attaches higher than it should.

My legs are generally the same length...the osteotomies did not alter my height.

I am having a lot of balance issues since having the accessory removed. If I lean over too far I start rocking back and forth on my feet and it is pretty disturbing. Some of that I attribute to the fact that I was only 3 months post-op on the opposing knees last surgery, but it seems to be more than that.

Gait is another area of concern for me. I feel as if I lose a step ever so often which makes being on a treadmill frankly dangerous. I tend to do all of my cardio on a stationary bike.

I have some other issues with my foot...my big toe curves inward and the OS has said that the joint connecting the big toe to my foot is nearly fused (as a result of arthritis ???). I also have bunionettes although they are not really symptomatic. The PT seemed to suggest that my foot didn't strike the ground appropriately in any way.

I think the PT was thinking out loud when he was talking about the orthodic being out of titanium...he must be thinking that I need something fairly light ????? Hard to tell...he did say that he didn't think there was anything that he could offer me in the way of PT that would help : ( He said that my knees were the worst that he had ever seen. The only ray of sunshine was that my right foot seems to be doing well (It still has it's accessory and it has only had one problem - avulsion fracture after the osteotomy in 2000. It healed very well).

So, yes...I do have some serious issues other than my feet and my medical history will be one for the books...

Thanks for your concern...

Jennifer