Dr. Timothy K. Durnin - 10/27/2007

Question
My 11 yo old son went to his pediatrician's today because he hurt his ankle earlier in the week. He's had trouble walking and trouble doing his P.E. class at school because of it. The pain was on his heel and up the back of his leg.

I thought it might be tendonitis or some kind of tear on his Achilles heel. My husband took our son today and the doc sent our son on to the hospital for some x-rays. They had to sit for a wet read.

What my husband was told was that a void/empty space had been found and that it was "probably congenital." They have referred him to the orthopedic practice in our area. Our son was just cleared from them after the broken arm with surgery he had a year ago.

Can you please explain the significance of a void in a bone? I found a reference tonight that says there are three such voids in the bone. I also saw something that referred to dysplasia and/or cancer?????

I know that congenital means present at birth. I have been concerned for some time about the way his foot turns and how he cannot seem to do heel to toe walking. There's other developmental history---gross and fine motor delays, but it may not be real siginificant to this.

From the bit I've been able to read so far, congenital wouldn't be so bad. The others, not so good.

Help!!!!

Thanks,
Elaine

Answer
Hi Elain,

Most certainly it is congenital osteo hypoplasia and a graft and tendonesis procedure can correct this if the Ortho deems necessary. Make sure if surgery is done, follow up post-operative therapeutic ultrasound is performed to minimize scar tissue proliferation so no long term disability will present itself further down the road. Don't accept the usual. "cut and run" mentality of surgeons and make sure the proper after care is followed up on.


Good Luck!

Dr. Timothy Durnin