I am on my paediatric placement at the moment. During my first week an 18 month old child presented to the clinic as his mother was concerned that the child did not tolerate walking and when the child was assisted to stand, he would weight bear on the medial aspects of both feet.
She also stated that she was trying to purchase some supportive shoes in hope this would help the child to stand.
On observation the child appeared alert and happy. He was interacting with the PT, the mother and myself well. He ws able to crawl to collect objects and toys effectively. When he was assisted to stand, he stood with both ankle extremely extremely everted and did not tolerate this position well. Ax found an increase in ROM in both ankle especially the talocrural joint and extreme ligament laxity.
The PT taped both ankles into a neutral position using fixamul and rigid tape and educated the mother on how to tape correctly. After the tape was applied the child was able to tolerate longer periods of standing and short burts of assisted walking. After the treaatment session the PT and I tried to brainstorm some ideas to help this child. The PT explained to me that even if the child is referred to podiatry, a splint or brace for both ankles will not be make until the child is WBing. Our issues is that the child wont WB without support, but they wont make the necessary support until the child WB.
Apart from taping to provide external stability we have yet to find a solution. Does any one have any ideas that both the PT and myself can try to help this young child to WB?
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