14 April 2016
Apes, Evolution, and the Root of all Evil in Disorders of the Foot
By Dr. Chong Keen Wai
As humans evolved from quadrupedal gait to a bipedal gait pattern, our Achilles tendon, in particular the gastrocnemius component of the Achilles tendon was required to undergo lengthening to allow a plantigrade stance. However, in reality, many of us still preserves some degree of gastrocnemius equinus contracture. The vast majority has mild or no symptoms and should rightfully be left alone. However, many disorders of the foot can be traced to the problem of gastrocnemius tightness and the ensuing biomechanical abnormalities. Problems such as flat feet, bunions, claw toes, diabetic Charcot arthropathy, stress fractures, midfoot osteoarthritis, metatarsalgia, planta fasciitis, Achilles tendinopathy are in one way or the other, caused by such a biomechanical problem. Increasingly, clinical outcomes and research has shown that solving this by physical therapy or by surgery, does lead to good clinical outcomes and minimal adverse effects. Surgical techniques has also changed. Minimally invasive gastrocnemius recession has improved recovery times and cosmesis.
28 April 2016
How to Manage Bow Legs with Knee pain
By Dr. Khong Kok Sun
Bowed knees (genu varum) are a common sight in the streets of Singapore. Some occur in the young but they are most seen in the middle-aged and older generation. They walk with a waddle and it is even evident that some require much effort to walk long distances. The typical history is often that the whole family exhibits the trait and the older ones might already have had knee replacements. Some have sustained knee injuries resulting in the loss of the medial meniscus. It is rare today to obtain a history of rickets as Vitamin D deficiency today is seldom encountered. The speaker will outline the causes of genu varum and what is available for non-operative as well as surgical options today including functional bracing, APOS Therapy, realignment surgery and partial knee replacement.