What happens when a ganglionectomy goes south
What happens when a ganglionectomy goes south?
- This patient had a ganglionectomy. Unfortunately, they tagged the joint capsule of the first MTP. By affecting the integrity of the capsule, as well as the surrounding musculature, she’s developed the beginnings of a hallux valgus (bunion) as well as hallux limitus (limited dorsiflexion of the first metatarsalphalangeal articulation).
- she has degeneration of the first MTP as well as an osteophytic crown at the distal aspect of the first metatarsal and tenderness over the capsule as well as the extensor hallucis tendon and proximal phalanx.
-dorsiflexion is 30° on this side, 50 on the opposite side. We need about 50° to have adequate for foot rocker
– she also has moderate external tibial torsion, right greater than left and a left anatomically short leg secondary to a femur fracture.
– Since the mobility of the first ray was limited, we worked on first Ray mobility as well as exercises to descend the 1st ray, with acupuncture for pain control.
-we are considering an orthotic to assist in raising the base and dropping the head of the first metatarsal to create more hallux dorsiflexion. When performed manually, she had a few extra degrees we would like to take advantage of.
-We will keep you posted :-)
#ganglionectomy #footproblem #footproblems #halluxlimitus #bigtoewoes #bunion #bunions #bunionsurgery
