Dear Rashmi
This patient is walking with a hyperextension at the knee and equinus at the ankle.
There is sill minimal shortening of the tibia however video also shows that patient has possibly some problem in the hip joint as well.
Correction of the equnius deformity and compensating the resudual shortening with heel raise is likely to tackle the hyperextension/valgus at the knee (provided there is no muscle weakness). It appears that he will benifit from TA lenghthening as mentioned in my previous mail, but he may also need some procedure at the hip.
I need to see an Xray of the hip and examine him thoroughly before any additional treatment can be finalised. This need to be comminunicated to the patient that providing a detailed treatment plan based only of few pictures of his leg taken from different angles without any previous medical record is not feasible.
Expected duration of stay after TA lenghthening will be 5 days and that he will be in a plaster cast for 6-8 weeks postoperatively and walking with help of crutches.Wheather he needs any additional procedeue will only be decided after clinical examination.
He should also be informed that he has a long standing(possibly by birth) shortenning of the leg, therefore he should not expect any treatment will miraclously give him a normal limb. At best he can expect an improvement as compared to the current clinical situation.
Thanks
Dr Jayant Arora
