Prolotherapy for 20 Year Old Ankle Injury
Clive Sinoff, MD
Mr. AS was a 58 year-old man when he consulted me in July 2005 for a work-related injury of his ankles. The injury occurred some 22 years earlier when he fell off a roof, landing on his feet and causing substantial damage to his ankles and feet. He had physical therapy for seven years following the accident, and eventually underwent arthodesis of both ankles and right foot. This helped his stability, but he continued to have significant pain. Therapeutic ultrasound, a TENS unit, and hot foot soaks only provided transient, mild relief.
At the time of his initial consultation AS reported pain between 5 and 7 out of 10 (with 10 being extreme). Using a cane, he was able to walk with difficulty, but was no longer able to participate in physical leisure activities or go shopping. In addition, he had developed some shoulder discomfort which he attributed to the use of a cane.
Examination showed a stilted gait with a moderate limp on the right. Ankle movement was 0 to 40 degrees on the left, and 5 to 30 degrees on the right. There was minimal inversion or eversion on each side and minimal movement of the toes. There was rigidity of the hind and mid-foot bilaterally. He had moderate tenderness around the malleoli, anteriorly and on the dorsum and arches of each foot. X-rays of the right foot showed irregular sclerosis and lysis of the tarsal bones with various areas of joint fusion with irregularity and some narrowing of multiple joints. X-rays of the left foot revealed fusion of most of the hind foot and mid-foot joints, including the tarso-metatarsal joints.
Read the full article at the Journal of Prolotherapy.