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Technique guide are not considered high yield topics for orthopaedic standardized exams including the ABOS, EBOT and RC.
What is the preferred orthotic device for a symptomatic adult foot deformity that is shown in Figure A, has no arthritis on radiographs, and responds to Coleman block testing as shown in Figure B?
Short walker boot
Accommodative custom orthotics
Lace up soft ankle brace
Medial hindfoot posting with arch support
Lateral hindfoot posting with recessed first ray
Select Answer to see Preferred Response
An 18-year-old male presents with recurrent ankle sprains of the left ankle and painful callus underneath the 5th metatarsal. Standing examination is shown in Figures A and B. During Coleman block testing the hindfoot is positioned in 3 degrees of valgus. The peroneus brevis and anterior tibialis have 4/5 strength compared to 5/5 strength in peroneal longus, gastrocsoleus complex, and posterior tibialis. Using a semi-ridged orthotic with a recess for the head of the first ray and lateral hindfoot posting has failed to improve symptoms. Which of the following is most appropriate as one part of the surgical plan??
Peroneus brevis to longus transfer with medial calcaneal slide osteotomy
First ray dorsiflexion osteotomy with plantar fascia release
First tarsometatarsal joint arthrodesis and metatarsophalangeal capsular release