Hi everyone, Would appreciate any views advice on a patient that I’m seeing, 70 yr old very fit and healthy male, high activity in that he walks up and down mountains! He has done the lot himilayers etc, he has no problems apart from trauma to his big toenails – which ultimately become painful and eventually fall off. Both are slightly onycauxic but not gryphotic. Nothing untoward foot posture wise, there is slight equinus approx 5-7 degrees dorsiflexion both soleus and gastrocs, all lower limb muscles 5/5 when testing resisted power, there is extensor substitution with hyper extension of both hallux swing-heel strike.
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Nail injury due to hyperextension
