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Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
Refractory peroneal spastic flat foot successfully treated with a cast in a girl
  1. Yuka Hadano,
  2. Tadashi Kimura,
  3. Makoto Kubota and
  4. Mitsuru Saito
  1. Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan
  1. Correspondence to Dr Tadashi Kimura; tadashi-kimura{at}jikei.ac.jp

Abstract

An 11-year-old girl presented with pain in the sinus tarsi and a foot deformity after spraining her left foot. She had flat foot due to spasticity of the peroneal tendon, which was difficult to correct manually. An imaging study revealed an accessory anterolateral talar facet (AALTF) and bone marrow oedema at the lateral aspect of the posterior talocalcaneal joint. We diagnosed peroneal spastic flat foot with possible involvement of sinus tarsi syndrome and AALTF. When conservative therapy failed, we applied a cast with the foot in full plantar flexion and an inverted position. After 4 weeks, the patient had a normal range of motion in the foot, the pain had resolved completely and the peroneal spasticity had disappeared. Orthopaedic treatment with a cast may be worth attempting before surgery in such cases.

  • orthopaedics
  • tendonopathies

https://doi.org/10.1136/bcr-2022-248979

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    Footnotes

    • Contributors YH, TK and MK had the idea of the article, wrote the manuscript and were involved in the patient’s care. MS was involved in writing and review of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.