walking on Medial Malleolus - 11 mo (Full Version)

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jppt -> walking on Medial Malleolus - 11 mo (June 20, 2008 3:11:09 AM)

Hi,

First time at this.  Looking for insight into helping my 11 month old patient.  Weight bearing, standing at table and cruising now, but feet fully everted, walking on medial malleolus 80% time with all toes splayed out to the side.  Recommendations? 
Primary Diagnosis: shunt placement at 3 months old due to blocked ventricles, but no complications since noted.  diagnosed with developmental delay.
New with Pediatrics.  Any suggestions?

Thanks!




gerry -> RE: walking on Medial Malleolus - 11 mo (June 20, 2008 7:39:38 PM)

Are the feet flexible?  Can you get them back to a good position?  Of course look at the entire body to see what is contributing to this.  There are many orthotic options.  Is ankle/foot range of motion good?  If so, you could try supra malleaolar orthotics that allow plantar/dorsifxion.  There are several types of orthotics made specifically for children who tend to have more weakness or low muscle tone.  Look at the rest of the foot to see what the forefoot does when the rear foot is held in a neutral position.  Lots to think about.  You might seek out an experienced pediatric PT nearby.  Good Luck!




jppt -> RE: walking on Medial Malleolus - 11 mo (June 24, 2008 6:18:10 PM)

Yes, I agree about experienced pediatric PT would be helpful.  We are unfortunately a bit in the boon-docks and I'm about as close to their 'specialist' as there is I guess.  That's why I've starting looking online to see what I can learn.

Partial answer to foot: yes, the foot is flexible, no noted tonal reason for foot alignment in weight bearing.  Foot in neutral... that I'll have to look at again this week and pay more attn to how hip alignment may be influencing this with weight bearing. 
Other tidbit:   The mom says baby's feet, especially the right was caught in the birth canal and was bent almost all the way back to the bone when he was born.  Baby is not upset or showing signs/symptoms of pain with weight bearing, just cruising along the table-top.

I've got a cold this week/little bug so I've had to give the PTA's the baby treats till I get over this.  Once I get to see him again, Ill see what I can find.

Hey... Thank you soo much for responding.  This forum opens up new options for PT insight, thank you very much.




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