Description of patient (type of occupation, indication of age, intensity of sport):
Young, patient 36 years old, very active, polio sequellae left but minor, did body pump until his injury few months ago. Since then crutches.
History and previous treatment:
End of last year injury to ankle with diagnosis of medial OC talar lesion treated with arthroscopy and drilling.
Current complaints:
Continuous pain medially in ankle, swelling, needs crutches to walk.
Physical examination:
Slightly swollen ankle, painful medial deep, ROM 20/0/20, weightbearing very difficult due to pain, good alignment lower legs, varus heel alignment.
Radiology:
X-ray:
[Picture 1]
Additional investigation (CT/MRI):
[Picture 2]
Images:
Case summary:
Medial talar OC lesion post drilling with heel varus due to polio with minor neurologic implications.
Question(s) to this case:
Slide osteotomy calcaneus, to combine with distal tibia?
Expert:
I miss the AP standing X-Ray. I would advise a CT to see if there are other reasons for the pain (loose bodies etc). Then probably lateralizing sliding calcaneal osteotomy 7.5-10 mm.