Dr. H talking Posterior Release

[Guest guest]

Hello Everyone..

We just got back from Dr Herzenberg's and I need some guidence. As some of

you know walks (when he walks) on his right toes.. His left foot is fine.

His right foot's outward rotation is perfect.. He isn't relapsing as far as the

cf goes.. However his tendon is very tight again and his dorsiflexion is 10

degrees equinous??? I know it means that he has none. His left foot is 5

degrees dorsiflexion. I hope I'm saying all this right. Anyways... He seems to

think that needs the posterior release, rather than doing a third tenotomy

on that foot. He also mentioned that if he doesn't get dramatic results than

the Ilizarov (sp) has had good results. He told me that a decision isn't

necessary right away. Which I'm greatful for!! I'm not ready to decide on any

of that. I did ask him if he thought a few more casts would do him some good

and he said he didn't think so. Because you can crush the bones in the upper

foot while trying to get a good stretch. I must confess we have not been

completely compliant with the shoes and bar and my dh seems to think that if we

keep him in the s like we are supposed to his foot could possibly go

down.. I don't know... I will email pics to Dr. Ponseti and I'm willing to go

see him again. I was just hoping I could get some advise from you guys.

Thanks in advance !

[Guest guest]

's son is having a similar problem I think - toe walking, perhaps you and

she should talk.

s.

Dr. H talking Posterior Release

Hello Everyone..

We just got back from Dr Herzenberg's and I need some guidence. As some of

you know walks (when he walks) on his right toes.. His left foot is fine.

His right foot's outward rotation is perfect.. He isn't relapsing as far as the

cf goes.. However his tendon is very tight again and his dorsiflexion is 10

degrees equinous??? I know it means that he has none. His left foot is 5

degrees dorsiflexion. I hope I'm saying all this right. Anyways... He seems to

think that needs the posterior release, rather than doing a third tenotomy

on that foot. He also mentioned that if he doesn't get dramatic results than

the Ilizarov (sp) has had good results. He told me that a decision isn't

necessary right away. Which I'm greatful for!! I'm not ready to decide on any

of that. I did ask him if he thought a few more casts would do him some good

and he said he didn't think so. Because you can crush the bones in the upper

foot while trying to get a good stretch. I must confess we have not been

completely compliant with the shoes and bar and my dh seems to think that if we

keep him in the s like we are supposed to his foot could possibly go

down.. I don't know... I will email pics to Dr. Ponseti and I'm willing to go

see him again. I was just hoping I could get some advise from you guys.

Thanks in advance !

[Guest guest]

> Hello Everyone..

,

I am going through an extremely similar situation. It is

interesting that Dr Herzenberg has mentioned First the posterior

release and then if that fails the Iilizarov. The Iilazarov was

suggested to me instead of the posterior release. My daughter has

also begun walking a little on her toes (right foot) due to

tightness in her achilles. Looking back her heels have never

dropped. She doesn't actually stand totally on her toes but her heel

does not touch the floor.....more she walks on the center of her

foot because the bone is out of alignment. She also has no

dorsiflexion on the right although the outward rotation is great on

both feet. Dr Herzenberg also is not comfortable with a 3rd tenotomy

or at her age of 3 and a half. How old is ? Does he have any

signs of rockerbottom? If he doesn't I would be concerned that he

will develop it if you do not get something done. That is what

happened to Grace. I was told to just wait and see what would

happen and now she has much more complicated problems. We were very

diligent with the DBB although at the beginning when she should have

been wearing it full time Dr Ponseti advised me to stop because she

was showing loose ligaments and was developing problems from that.

Did have 2 tenotomies on both feet or just on the right? How

old was he when his treatment was finished? Also Im just curious

but how often did you put him in the DBB? It is very stressing I

know! I would like to know what Dr Ponseti says if you email him.

I have gotten extremely different opinions from the 3 Drs we have

seen about Grace. Take care, jennifer

> We just got back from Dr Herzenberg's and I need some

guidence. As some of you know walks (when he walks) on his

right toes.. His left foot is fine. His right foot's outward

rotation is perfect.. He isn't relapsing as far as the cf goes..

However his tendon is very tight again and his dorsiflexion is 10

degrees equinous??? I know it means that he has none. His left

foot is 5 degrees dorsiflexion. I hope I'm saying all this right.

Anyways... He seems to think that needs the posterior release,

rather than doing a third tenotomy on that foot. He also mentioned

that if he doesn't get dramatic results than the Ilizarov (sp) has

had good results. He told me that a decision isn't necessary right

away. Which I'm greatful for!! I'm not ready to decide on any of

that. I did ask him if he thought a few more casts would do him

some good and he said he didn't think so. Because you can crush the

bones in the upper foot while trying to get a good stretch. I must

confess we have not been completely compliant with the shoes and bar

and my dh seems to think that if we keep him in the s like

we are supposed to his foot could possibly go down.. I don't

know... I will email pics to Dr. Ponseti and I'm willing to go see

him again. I was just hoping I could get some advise from you

guys. Thanks in advance !

>

>

>

>

[Guest guest]

,

Thanks for replying.. I've read about your daughter Grace's case. You're

one strong woman.

is only 17 months. Rockerbottom has never been discussed. His feet

are atypical and he has very high arches. had a hard case. He was casted

4 times by a non-Ponseti doc and they 15 times by Herzenberg. I know that's way

far off. That's when we decided to see Ponseti with Herzenberg's blessing.

Actually he suggested it. Ponseti recommended the second set of tenotomies and

the mitchell shoes. Seems to me he was corrected after that second set in June.

It's funny that when he walks, he's totally on his right toes, but just

today he was standing against the stove and had his foot flat but at an angle...

He also said that the posterior release may not be needed on the left foot, only

the right.

As far as the dbb goes. We couldn't get to sleep in it. But he

would wear it all day without problems. so for the longest time that's what we

did. So now that he wants to walk its not been that easy to get more time in

it. Dr H told us he had to be in it at least 10 hours a day. So that's what we

did (for the most part). We would put them on at 7 in the morning and we hoped

that he would wear them till about 5. My mom watches him during the day and

we'd often find that they were off before we went to pick him up.. I'm not

blaming my mother but that didn't help. And we could've put them on then but we

didn't. This is our fault completely because I know if we had done like we

were supposed to do from the beginning we wouldn't be going thru this right now.

This is terribly stressful!

-------------- Original message --------------

> Hello Everyone..

,

I am going through an extremely similar situation. It is

interesting that Dr Herzenberg has mentioned First the posterior

release and then if that fails the Iilizarov. The Iilazarov was

suggested to me instead of the posterior release. My daughter has

also begun walking a little on her toes (right foot) due to

tightness in her achilles. Looking back her heels have never

dropped. She doesn't actually stand totally on her toes but her heel

does not touch the floor.....more she walks on the center of her

foot because the bone is out of alignment. She also has no

dorsiflexion on the right although the outward rotation is great on

both feet. Dr Herzenberg also is not comfortable with a 3rd tenotomy

or at her age of 3 and a half. How old is ? Does he have any

signs of rockerbottom? If he doesn't I would be concerned that he

will develop it if you do not get something done. That is what

happened to Grace. I was told to just wait and see what would

happen and now she has much more complicated problems. We were very

diligent with the DBB although at the beginning when she should have

been wearing it full time Dr Ponseti advised me to stop because she

was showing loose ligaments and was developing problems from that.

Did have 2 tenotomies on both feet or just on the right? How

old was he when his treatment was finished? Also Im just curious

but how often did you put him in the DBB? It is very stressing I

know! I would like to know what Dr Ponseti says if you email him.

I have gotten extremely different opinions from the 3 Drs we have

seen about Grace. Take care, jennifer

> We just got back from Dr Herzenberg's and I need some

guidence. As some of you know walks (when he walks) on his

right toes.. His left foot is fine. His right foot's outward

rotation is perfect.. He isn't relapsing as far as the cf goes..

However his tendon is very tight again and his dorsiflexion is 10

degrees equinous??? I know it means that he has none. His left

foot is 5 degrees dorsiflexion. I hope I'm saying all this right.

Anyways... He seems to think that needs the posterior release,

rather than doing a third tenotomy on that foot. He also mentioned

that if he doesn't get dramatic results than the Ilizarov (sp) has

had good results. He told me that a decision isn't necessary right

away. Which I'm greatful for!! I'm not ready to decide on any of

that. I did ask him if he thought a few more casts would do him

some good and he said he didn't think so. Because you can crush the

bones in the upper foot while trying to get a good stretch. I must

confess we have not been completely compliant with the shoes and bar

and my dh seems to think that if we keep him in the s like

we are supposed to his foot could possibly go down.. I don't

know... I will email pics to Dr. Ponseti and I'm willing to go see

him again. I was just hoping I could get some advise from you

guys. Thanks in advance !

>

>

>

>

[Guest guest]

,

Has Dr H taken X-rays of 's foot? I only ask because everytime we see Dr

Mosca he is very strenuous to his interns on the point that the cavus present in

Kai's foot makes it look like his heel is in equinus, but in fact only the

forefoot is in equinus. He actually covers the entire forefoot with his hand

and then dorsiflexes the foot and looks only at the hindfoot.

It is just a thought. I know that Dr Herzenberg is a fine doctor and experience

with atypical clubfoot, but sometimes even the great doctors miss something ;-)

Point in fact, a doctor from Europe (Spain, I think) actually showed Dr Ponseti

the mechanics of an atypical clubfoot .. he was basically unfamiliar with it

until a year and a half ago!

Good luck.

Angel

Re: Re: Dr. H talking Posterior Release

,

Thanks for replying.. I've read about your daughter Grace's case. You're

one strong woman.

is only 17 months. Rockerbottom has never been discussed. His feet

are atypical and he has very high arches. had a hard case.

[Guest guest]

Angel,

Hmm.. Interesting. He didn't take x-rays yesterday when we went but he has

in the past. We don't go back for 4 months. Maybe I'll email him and see what

he has to say...

Thanks

--------- Re: Re: Dr. H talking Posterior Release

,

Thanks for replying.. I've read about your daughter Grace's case. You're

one strong woman.

is only 17 months. Rockerbottom has never been discussed. His feet

are atypical and he has very high arches. had a hard case.

[Guest guest]

It seems like Dr. H is talking more and more about doing the external

fixator these days. I love Dr. H and so does Collin and we are truly

considering it...but at the same time it scares me because this is

his " new " way to treat certain clubfoot related problems. I've been

doing as much research as possible on it (a great thank you goes out

to Boothe " Grace's Mommy " for the help with that. I don't

think any other doctors are using the external fixators as often for

clubfoot corection, most of the research I've read shows fixators

being used for limb lenghting etc. or clubfeet that haven't had

previous treatment. It's always hard with clubfoot because it is

controversial and some believe there is no real cure, etc...I always

worry about new treatments and going that way because someone always

has to be the test subject and that just scares me so much. We go

back in March to discuss the taylor spatial frame fixator for

Collin. I think we will most likely go ahead but it will be a hard

final decision, I just don't know what else to do I feel like we have

exhausted all of our options, I don't think we have any other options

at this point that I know of.

Michele

Collin's story at http://www.geocities.com/chele323232