Nail-patella syndrome, skewfoot.
The patient received her previous SAFO on 10/05/2000. Her mother stated that is was leaving marks on her skin; however, she did not bring the brace with her today. It has not been quite 6 months; therefore, we are going to try to adjust the old one when she brings it in later this week. I did cast the patient today for a new brace, which will be made when she is no longer able to wear the old one. She is a 3-year-old female. The patient has no known allergies. She is not taking any medication, and she is active community ambulator. She has not had any surgery.
On weight bearing, the patient pronates at the midfoot and her forefoot is adducted. Her heel is in valgus but correctable. She can get to 90 degrees; however, her forefoot angle has approximately a 15-degree varus, and she then pulls into adduction. She does not have skin breakdown. She is having difficulty with her medial malleolus. There is a callus that has built up. Her mother stated that this is from the brace. The casting procedure went well.
Fabricate left SAFO. Casting and measurement.
We will see the patient at the end of the week for adjustments to her old brace to enable her to wear it for a longer period of time.
