Case of the Season #2

55 year old woman

Patient: Female, 55 years old, 140 lbs


Chief complaint


In our second case of the season, our patient complains of pain in the third and fourth metatarsal heads. She experiences pain in her right foot only.


Examination Findings


  • Moderate hallux abducto valgus deformity
  • Diffuse hyperkeratosis sub second metatarsal B/L
  • Deviated and hypermobile first metatarsal
  • Multiple digital contractions.



Biomechanical Evaluation


Upon visual inspection and physical palpation, she has a marked compensated rearfoot varus, deviated short and hypermobile first metatarsal.


Treatment Plan


Prescribe a semi-rigid orthotic with four degrees rearfoot posts, 1/8″ bar with a first met cut out B/L, narrow grind, followed by  fabrication of bilateral digital orthoses. 





This type of deformity responds amazingly well when the forefoot deformity is addressed. Learning how to fabricate and mold digital orthoses will dramatically improve the long-term prognosis.


The semi-rigid and fully posted orthotic ensures support and adequate joint control. Keep the device low bulk without the use of thick extensions or additions, in order to ensure patient compliance and maximum comfort for the digital device.


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