Re: Questions regarding correction (and overcorrection) of CF-Angel

[Guest guest]

Angel,

It is 70* for the whole time unless there is a specific reason to

reduce it

(loose ligaments or atypical clubfoot requiring the reduction). The

70*

PREVENTS a relapse.

Just had a question about your post. Why is it that the atypical

clubfoot requires the reduction in degree? I can understand why you

would reduce for loose ligaments. Thanks in advance for explaining.

KK

> " Should I order s?? Or are the Markells fine? Does

everyone get blisters with the Markells? "

>

> The Markell shoes work just fine for a vast majority of people. If

you have Kori's list of Tips and Tricks you should be set to go into

the Markells without problem. Also be aware that if the 000 appear

too big, they do offer a 0000 now ... many orthotists are still not

aware of this fact.

>

> " Also, how are you supposed to know if the foot looks corrected

enough? "

>

> FOr the most part you would know if it was not. If the angle is

70* rotation in this cast, and when the foot comes out it looks like

a normal foot but curved slightly to the outside it likely is

corrected. If for any reason you feel like it doesnt look like a

normal foot - ANY REASON - feel free to post pics to CFPics and also

ask the doc about it. This was our first clue that there was a

problem ... I remember the disappointment of seeing Kai's foot come

out of that cast and still not looking normal.

>

>

> " I'm having a hard time dealing with the fact that the foot will be

so overcorrected. I know this is because the foot will start to

relapse and it will fall " into place " but my question is when does

this relapsing occur? "

>

> This is actually inaccurate. The foot doesnt relapse into a

neutral position, it stabilizes with walking (that is the when). 70*

is NOT an unnatural rotation. See if you can do it with your

foot ... I can do almost 90* ... you will realize that this really is

not a radical degree.

>

> " Is the CF set at 70 degrees for the 3 years that the DBB is worn??

Or are the degrees gradually decreased? It just doesn't seem right

to me that a 2 year-old should have a foot set at 70 degrees.

Somebody please enlighten me. "

>

> It is 70* for the whole time unless there is a specific reason to

reduce it (loose ligaments or atypical clubfoot requiring the

reduction). The 70* PREVENTS a relapse. It keeps the ligaments and

muscles that would otherwise pull the foot back in supple. It is the

same concept as stretching before and after excercise ... or

stretching for carpal tunnel syndrome. By 2 years old most

children's feet fall into a neutral position when out of the brace

and are only held in that stretch for sleeping.

>

> And above all ... 70* is nothing compared to the alternative. If

70* is what it takes to prevent the foot from returning to the

clubbed form, isnt it worth it?

>

> Angel

>

>

[Guest guest]

" Just had a question about your post. Why is it that the atypical clubfoot

requires the reduction in degree? "

It isnt even all atypical clubfeet that require this, so it is complicated! The

biggest reason is that if you externally rotate some atypical cf to the full 70*

it causes a secondary deformity, visualized by the presence of a crease on the

outside of the foot. What happens is that the midfoot is in a unusual position

and doesnt flex with the forfoot ... so only the metatarsals are abducted.

Dr Ponseti and others have played around with this quite a bit. Kai's shoes are

at 55* ... a little girl in Seattle, Sadie, her shoes are both at 10* (or were

at one time, at least).

Angel

[Guest guest]

That's intresting. Thank you for explaining. How long has Kai's been

set at 55*? Ava's were initially set at L 60* and R 70* for 2 1/2

months then reduced to L 50* and R 60* and it will be a little over

three months. The R is more severe but am wondering how much further

down it will be reduced? She only did 2 1/2 months of 23/7 and is now

only doing 20/7. We will see Dr. P in about 2wks. Thanks again for

your answers.

KK

> " Just had a question about your post. Why is it that the atypical

clubfoot requires the reduction in degree? "

>

> It isnt even all atypical clubfeet that require this, so it is

complicated! The biggest reason is that if you externally rotate

some atypical cf to the full 70* it causes a secondary deformity,

visualized by the presence of a crease on the outside of the foot.

What happens is that the midfoot is in a unusual position and doesnt

flex with the forfoot ... so only the metatarsals are abducted.

>

> Dr Ponseti and others have played around with this quite a bit.

Kai's shoes are at 55* ... a little girl in Seattle, Sadie, her shoes

are both at 10* (or were at one time, at least).

>

> Angel

>

>