Rohit Madhav

#London based #Orthopaedic Surgeon, #Trauma, #Foot & #Ankle expert, Fan of Arsenal, Ferrari, F1 and 20/20 Cricket.

[Rohit Madhav @AnkleFootMotion]

@DrJN_SportsMed Split brevis tear plus low lying muscle mass. Differential accessory muscle

[Rohit Madhav @AnkleFootMotion]

@tomgoom The biggest cause of repetitive stress fracturing and non union is biomechanics ie cavovarus foot /forefoot adductus. Always need to address this for long term resolution.

[Rohit Madhav @AnkleFootMotion]

@kashakhtar @NHSBartsHealth @QMULBartsTheLon Congrats, you are progressing amazingly well, next journey bare below elbows! 🤣

[Rohit Madhav @AnkleFootMotion]

@BostonFootAnkle Great tips, I tend to use the para-ehl arthroscopy portal longitudinal incision and then turn blade and skirt phalanx laterally, whilst flexing IPJ slackening the fhl .

[BBC News (UK) @BBCNews]

Husband guilty of conspiring to murder Carol Morgan https://t.co/BZlHYhoeWI

[Rohit Madhav @AnkleFootMotion]

@BostonFootAnkle On the odd occasion get PF, valgus rotation or distraction, esp 100% shifts. Same way : back out screw enough to re reduce and use second screw to hold then replace 1st screw. Tbh with the flatter feet, I often dial in a bit of plantarization (not angulation).

[Rohit Madhav @AnkleFootMotion]

@dr_irfan_malik Some things can’t be described in terms of severity and occasionally things get missed. More so in MSK reports, I always look at images for that reason.

[Rohit Madhav @AnkleFootMotion]

@DrJN_SportsMed Poss Relatively “weaker” GS and PL hence flexor overuse/1st ray instability?

[Rohit Madhav @AnkleFootMotion]

@orthotraumamd I still can’t understand the need to X-ray these! My preference is dynamic uss to check gapping in PF, and any soft tissue (fat) interposition etc.

[Rohit Madhav @AnkleFootMotion]

@traumaticum Would you advocate over drilling? Does it leave a risk of fracture when torsional force is applied ? I tend to leave them as is.

[Rohit Madhav @AnkleFootMotion]

@traumaticum Prob kenalog or triamcimolone. Do keep out of the sun!

[Rohit Madhav @AnkleFootMotion]

@FootAndAnkleMD Amazingly powerful corrections. This is more important than the small scars. Was the right without jig?

[Rohit Madhav @AnkleFootMotion]

@BostonFootAnkle Thanks, that will help to reassure my patient who is pain free and eager to return to sports, 8 weeks post surgery! Only went there to get a post op check X-ray! Which shows appropriate alignment/callus / union.

[Rohit Madhav @AnkleFootMotion]

@BostonFootAnkle Great technique. I’ve recently seen a report from a US DPM saying non fixation of a bunionette osteotomy would be considered malpractice in the USA!

[Rohit Madhav @AnkleFootMotion]

@AbbasianAli @DrJN_SportsMed Agree. Full leg weight bearing alignment X-rays / EOS would be useful.

[Rohit Madhav @AnkleFootMotion]

@DrJN_SportsMed Possible chronic exertional deep posterior compartment syndrome?

[Rohit Madhav @AnkleFootMotion]

@DrJN_SportsMed According to Bard not fully known but:
One theory: microtrauma to the tendon, which triggers the release of growth factors and other proteins that promote healing. Another is it increases blood flow to the area, which helps to deliver nutrients and oxygen to the injured tissue.

[Rohit Madhav @AnkleFootMotion]

@FootAndAnkleMD @pmangoneMD @rkh_md But non unions of Med mal are higher so fixing medially for stability maybe preferable.

[Rohit Madhav @AnkleFootMotion]

@Flawless_Physio Found the link to fill article with empty distal end calcaneum X-ray.

https://t.co/xorkmBD7m4

[Rohit Madhav @AnkleFootMotion]

@Flawless_Physio Also occasionally CCJ can be unstable, and subluxate/dislocate. The text is a bit mixed up for some reason, but was published as a tip for stabilization. Came with hx of unstable ankle but all the time the mid-foot CCJ was dislocating!

[Rohit Madhav @AnkleFootMotion]

@Flawless_Physio Great summary. With ccj and tmtj soft tissue injuries, delayed scans can be resonably normal but clinically the motion is stiff/abnormal, and the foot can’t adapt to the ground causing ongoing lateral column pains, often after “minor” kerbside sprains. Examination is the key.