New procedure can fix calf, foot disorder

He has overcome a developmental disorder to compete on the ice, but a physical abnormality almost forced one boy to give up his passion.

However, he had a new procedure that fixed his feet and saved his figure skating career.

For 11-year-old Harrison Sokol, skating is everything.

He says, "I've been skating since I was four, and I pretty much like everything about it."

Harrison has an autism spectrum disorder, but when he puts on a pair of skates, there is no stopping him.

Harrison’s mom, Laura Sokol, says, "There's no telling him what he can or can't do."

Autism is not Harrison's only challenge. He was born with a painful abnormality of calf muscle and bone that made him more and more unstable.

"His feet started rolling in and it just got worse and worse."

To get Harrison back on track, Dr. Mark Gorman performed his own spin on a procedure called gastrocnemius recession to lengthen Harrison's Achilles' tendons.

Dr. Gorman says, "We stretch the calf muscle, the gastrocnemius muscle where the tendon and muscle come together, right at that area without damaging the tendon."

Then a custom-fit conical titanium implant was placed between the heel bone and ankle bone in each foot to restore normal stability and mobility.

A year after surgery, Harrison is back on the ice, solo skating, ice dancing, and winning gold. He is a tough competitor heading toward his biggest challenge yet: the 2013 International Special Olympics.

Now that Harrison's stability and motion problems have been surgically repaired, doctors say it is likely to be a permanent solution.

Though future complications are unlikely, the conical implants in his feet can easily be removed or replaced, if necessary.

RESEARCH SUMMARY

BONE AND MUSCLE DEFECT: Birth defects can occur in any bone or muscle, although the bones and muscles of the skull, face, spine, hips, legs, and feet are affected most often. Bones and muscles may develop incompletely. Also, structures that normally align together may be separated or misaligned. Usually, bone and muscle defects result in abnormal appearance and function of the affected part of the body. Most of these defects are repaired surgically if symptoms are troublesome. Often, the surgery is complex and involves reconstructing deformed or absent body parts. ( Source: Home Health handbook)

ABNORMALITIES OF THE FEET: Clubfoot (talipes equinovarus) is a defect in which the foot and ankle are twisted out of shape or position. The usual clubfoot is a down and inward turning of the hind foot and ankle, with twisting inward of the forefoot. Sometimes the foot only appears abnormal because it was held in an unusual position in the uterus (positional clubfoot). In contrast, true clubfoot is a structurally abnormal foot. With true clubfoot, the bones of the leg or foot or the muscles of the calf are often underdeveloped.

FIXING IT: Gastrocnemius recession is commonly performed to correct an equinus contracture of the ankle that may accompany foot and ankle pathology in adults. The equinus deformity leads to excessive pressure and pain that manifests as plantar fasciitis, metatarsalgia, posterior tibial tendon insufficiency, osteoarthritis, and foot ulcers. The procedure is also performed on individuals who have limited ankle dorsiflexion. ( Source: American Academy of Orthopedic Surgeons)

A NEW SPIN: Doctor Mark R. Gorman is changing the game. He's using a custom-fit conical titanium implant placed between the heel bone and ankle bone in each foot, to restore normal stability and mobility. "We used to actually cut a piece of bone either from the hip or from the tibia and put it in there and rough up the bones on the calcaneus heel bone and the ankle bone the talus, rough that up and put that in and put somebody in a cast for two to three months and that would become a solid piece of bone." Dr. Gorman said. "No foot pain, no leg pain, no pathology."


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