Re: good foot question

[Guest guest]

At Dr. Ponseti's web site, it says:

" Following correction the clubfoot deformity tends to relapse. To

prevent relapses, when the last plaster cast is removed a splint

must be worn full-time for two to three months and thereafter at

night for 2 to 4 years. The splint consists of a bar (the length of

which is the distance between the baby's shoulders) with high top

open-toed shoes attached at the ends of the bar in about 70 degrees

of external rotation. A strip of plastizote must be glued inside the

counter of the shoe above the baby's heel to prevent the shoes from

slipping off. The baby may feel uncomfortable at first when trying

to alternatively kick the legs. However, the baby soon learns to

kick both legs simultaneously and feels comfortable. In children

with only one clubfoot, the shoe for the normal foot is fixed on the

bar in 40 degrees of external rotation. During the daytime the

children wear regular shoes. Shoes attached to the bar often cause

pressure blisters and sores. To prevent such distressing problems,

we have devised a new foot and ankle abduction orthosis that holds

the foot firmly and comfortably in place, causing no sores. "

http://www.vh.org/pediatric/patient/orthopaedics/clubfeet/parents.htm

l

We have been aware of many parents using the Ponseti method for a

child with one clubfoot. When they mention it, the non-clubfoot

side is set at 40-45 degrees and different from the clubfoot side.

But perhaps your doctor has a reason for doing things differently

than recommended by Dr. Ponseti.

and (3-17-990

>

> Hi everyone, I just have to ask those who have been through the

DBB

> if it is normal that they turn the good foot out as far as the

club

> one. I know the dr said it was for symnical(sp) reasons but I

don't

> understand it, his club foot looks good and straight and then his

> good foot is turned out more than the club one is. Any ideas????

> Corrina

> Son rht club dbb 23/7 in for 7 weeks

[Guest guest]

When my daughter went into the DBB, the doctor set both her feet at

the same outward rotation, and it only seemed like about 60 degrees

to me (she is unilateral, right foot CF only). However, I think we

may have been one of the first to insist on using the DBB, he

generally prescribed a DAFO, he's just starting to get in line with

Dr. P's bracing methods (he was using Ponseti method casting, but

not bracing). So when I came home, I just switched it to around 45

on the left, and 70 on the right (at least I think so!) and Ava is

fine, and I'm happy knowing it's in line with Dr. P's protocol. I

don't know who your doctor is, but maybe they just got confused or

don't have it right if they're kind of new to the Ponseti method.

Just my two cents!

, mommy of:

Guinevere, on, Ava 8/4/04 right CF DBB 23/7

> >

> > Hi everyone, I just have to ask those who have been through the

> DBB

> > if it is normal that they turn the good foot out as far as the

> club

> > one. I know the dr said it was for symnical(sp) reasons but I

> don't

> > understand it, his club foot looks good and straight and then

his

> > good foot is turned out more than the club one is. Any ideas????

> > Corrina

> > Son rht club dbb 23/7 in for 7 weeks

[Guest guest]

Hi Corrina,

This sounds very strange to me. I would definitely email doctor Ponseti to

see if this makes any sense if no one has info about why the good foot

should be at approximately 45 degrees, no less, no more.

I learned the hard way what happens if the good foot is at zero degrees,

though. Since I did not receive any support on the use of the shoes and

didn't pay attention to what her good foot was set at, when I changed the

shoes to a bigger size, I put her clubfoot at 70 and her good foot at 0. Her

previous doc never checked the shoes for several weeks, and her good leg and

foot started doing bizarre things. AT her checkup, the doc still did not

examine the shoes and said we'd have to keep an eye on it!

I came home from the checkup and posted a message on this list asking what

the degrees of the good foot should be, received the reply 45 degrees,

changed her shoe,and within a week her foot and leg were back to normal!

Whew.

If you would like, I can email my current doctor, Herzenberg, and ask him

why the good foot is set at ~45 degrees and if it's ok to do 70 degrees. May

I ask who your doctor is?

Hope this helps, Joanne W.

Message: 22

Date: Tue, 15 Feb 2005 17:37:09 -0000

Subject: good foot question

Hi everyone, I just have to ask those who have been through the DBB

if it is normal that they turn the good foot out as far as the club

one. I know the dr said it was for symnical(sp) reasons but I don't

understand it, his club foot looks good and straight and then his

good foot is turned out more than the club one is. Any ideas????

Corrina

Son rht club dbb 23/7 in for 7 weeks

[Guest guest]

I'm surprised your son would even tolerate the good foot set out to

70 degrees. Since that foot never had any manipulations, I think it

would be painful. Dr. P says the good foot should be at 40-45

degrees and many times even less than that. My son was at 40 degrees

for about a year and then had to go down to 20 degrees because he

would walk with his good food completley out. Within a week of going

to 20 degrees he walked normal.

>

> Hi everyone, I just have to ask those who have been through the

DBB

> if it is normal that they turn the good foot out as far as the

club

> one. I know the dr said it was for symnical(sp) reasons but I

don't

> understand it, his club foot looks good and straight and then his

> good foot is turned out more than the club one is. Any ideas????

> Corrina

> Son rht club dbb 23/7 in for 7 weeks