I had a sixty-ish year old active female who loved to walk. Litigation defence usually includes comparison with standard practices, and the selection of expert witnesses and their opinions in any one case can often determine an outcome. Further, lets assume that the patient was examined on a particularly bad day, and that she does not really have painful crepitus; Decompressing the joint hav splint for hallux valgus correction a shortening osteotomy would still be problematic because it would exacerbate the long second metatarsal and associated painful hammertoe.
As a result of lost IPJ motion ironically, it was likely in fixed extensus pre-op to compensate for the absent MTP dorsiflexion hav splint for hallux valgus correction, some 1st MTP dorsal flexion return is needed for hallux propulsion. Not enough information was given to determine if this is the case. The pathologic forces from the skew-foot that have contributed to the forefoot deformity would certainly ruin even the best possible immediate post-op outcome. Billing Multiple Hammertoe Repairs on One Toe If patient has a hammertoe deformity at both proximal interphalangeal joint and distal interphalangeal joint of the toe, can CPT be billed twice or only one time per toe to correct the contracture deformities. But we do know several important facts regarding this case.
This young lady has a promising basketball future ahead of her with Division 1 college scholarships almost certain. To address the chief complaint, the hallux IPJ requires fusion which will realign the joint in sagital plane and negate the EHL loss. A typical PIPJ arthrodesis will correct the hammertoe. Other interesting features include significant hypertrophy of the lateral growth plate on proximal 1st metatarsal creating adduction. I would take a felt medial longitudinal pad and apply it to her insole in the same location you would place a met pad, round side forward, long tapered side following the course of hav splint for hallux valgus correction plantar fascia.
I would like to see specific description of hav splint for hallux valgus correction "toe fasciotomy. First, do no harm. This is a very interesting case, with multiple issues occurring simultaneously. As a result of lost IPJ motion ironically, it was likely in fixed extensus pre-op to compensate for the absent MTP dorsiflexionsome 1st MTP dorsal flexion return is needed for hallux propulsion. If you still have problems with HealthNet or its medical director, assuming you are member of the APMA, contact the staff person for the Health Systems Committee for assistance.
She sheepishly mentioned that a friend of hers was an orthopedic surgeon who looked at her foot informally. I would not operate on her until a concerted effort of conservative care failed. Why was this denied. Used on two adjacent toes, under lapping is usually resolved as well as the sagittal plane deformity. The xrays provided do not include a weight-bearing lateral. Multiple Respondents In the Australian community of podiatric surgeons it is uncommon for hav splint for hallux valgus correction hammertoe deformities to be primarily treated by amputation in a healthy individual.