Last week we went to the orthopedic clinic at Sydney Children's Hospital for the Dude's two-year check-up. (For those who don't know, he was born with severe talipes equinovarus or club feet, just like such sex symbols as Lord Byron and Dudley Moore. He's already had two lots of reconstructive surgery.)
The orthopedic specialist thinks that there may be a "coalition in the subtaler joint" or, in plain English, a bridge of bone or cartilage forming between the bones of the heel joint just below the ankle. Alternatively, it might simply be wear and tear on the joint as a result of his earlier surgeries. The prognosis is that he will probably need surgery to fuse the joint, removing the small amount of movement that he has, but also removing the pain.
Tomorrow we return to Sydney Kids for x-rays and a CT scan, then back to the clinic to see what the scan shows and get the diagnosis from the doctor. He may prescribe orthotics in the short term, saving the surgery for when the Dude is a bit older, but we are steeling ourselves for the worst-case scenario.
On the plus side, it's probably only the right foot that will need the surgery, so if he does have it he can use crutches while he convalesces, rather than a wheelchair. I couldn't imagine lifting him in and out of a wheelchair at this age!
It was interesting going to the orthopedic clinic last week because it is school holidays. Usually when we go there are just a few kids, mostly like the Dude coming for routine check-ups on existing conditions, and the odd broken limb. Last Thursday there were five children with broken arms and one with a broken leg, fresh from the emergency ward, all lined up in one examination room -- and that was at 8.30am! I'll never doubt those ambulance officers and pediatric ER nurses who dread the school holidays again.