Genus Varus(bow-leggedness).
6 years post surgery Tendon Achilles rupture.
Poor skin conditions. Dry skin. Open wound.
On interview he told me that the doctor has removed his Achilles Tendon.
I didn't believed at first as he would stil plantarflex, even with a muscle strength of Grade 4.
On examination, I notice the contour of the gastrocnemis is tilted to the medial side and hence I suspect that it has been inserted into his tibialis posterior which in turn inserts into his cuneiform and metatarsals.
The muscle bulk of his gastrocnemius is significantly larger on his injuried side. This might be due to the heavy loading demanded on the muscle during daily activities.
The direction of the muscle fibres are prone to sustain a greater resultant force during plantar flexion.
His gait pattern is also deviated from norm. He has significantly reduced plantar flexion of foot during toe-off phase. He basically lift off his whole leg during lift off. He does so by external rotating his hip.
He also have difficulties doing single leg standing which might indicate problem in balance.
Overall Posture:
Increase in thoracic kyphosis leads to his occassional back pain.
General health:
Hypertension. Controlled by medication.
Well, I really need to praise him on his diet for now! He eats more healthy food than me. :P
Thanks for lending me your NDS.
Do provide me some feedback on the case if you are in any case, a PT or medicine student. :P
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