Our reply from Ponseti:

[Guest guest]

I have reviewed the movie and photos you sent. The pictures

indicate the right foot is straight. Although the movie is dark and

hard to see, it appears when he runs the right foot turns in a

little. In the pictures when he stands, it looks like the foot is

flat, but his leg is not straight, that is there is some flexion at

the ankle. To be certain of the degree of ankle dorsiflexion you

should have Elijah lie on his back and keep his knee straight while

you place the palm of your hand against the sole of his foot and

press the foot up into dorsiflexion. Take this photo from the side

and take a photo of each foot for comparison. In the standing views

from the front and back it looks like there is a slight varus

(turning in) of the right heel.

I recommend you put the bar straight again, removing the

dorsiflexion of 5 degrees so the bar is straight. Usually we

recommend the distance between the center screw on the left shoe and

the center screw on the right shoe on the footplate of the brace be

the same as the distance from the outside of the child's left

shoulder, across his chest, to the outside of his right shoulder.

However, if you lengthen the bar about 1 to 2 inches, then probably

the shoes will stay on through the night.

Even if the heelcord is slightly tight, I would not do anything now

since he walks well. Another heelcord tenotomy can be done later on

in several months if necessary.

The foot is short and stubby and these feet are difficult to

maintain in the open toe lace up shoes often used on the bar. A

local craftsman, , makes a three strap sandal on a

molded plastic footplate on a bar which we have found to be

indispensable in maintaining the correction in these feet. If you

are interested in obtaining the brace, you can contact him

at mdsgns@... or call 319 653-7435.

If you go to the web site www.global-help.org and click on

Publications, you can download a copy of Clubfoot: Ponseti

Management which is very informative.

There is a good family support group at

http://groups.yahoo.com/group/nosurgery4clubfoot

I.V. Ponseti, M.D.

I figured his response would be such so I headed out this morning to

Gulfport to have his bar straightened before receiving this email.

No need to spread the shoes out, I know that his feet will stay in

the shoes with the bar straight. Tonight he'll be back in them and

into his usual routine.

Once we see a Dr in Hawaii, preferably Durkin, he can deal with

whether or not to perform another tenotomy. Im SO relieved to hear

that he's not relapsing.... I was, in no way, looking forward to

the battles w/ the military and Tricare that lie ahead had it been a

relapse.

Thanks to everyone for you support and advice,

Lori

[Guest guest]

I have reviewed the movie and photos you sent. The pictures

indicate the right foot is straight. Although the movie is dark and

hard to see, it appears when he runs the right foot turns in a

little. In the pictures when he stands, it looks like the foot is

flat, but his leg is not straight, that is there is some flexion at

the ankle. To be certain of the degree of ankle dorsiflexion you

should have Elijah lie on his back and keep his knee straight while

you place the palm of your hand against the sole of his foot and

press the foot up into dorsiflexion. Take this photo from the side

and take a photo of each foot for comparison. In the standing views

from the front and back it looks like there is a slight varus

(turning in) of the right heel.

I recommend you put the bar straight again, removing the

dorsiflexion of 5 degrees so the bar is straight. Usually we

recommend the distance between the center screw on the left shoe and

the center screw on the right shoe on the footplate of the brace be

the same as the distance from the outside of the child's left

shoulder, across his chest, to the outside of his right shoulder.

However, if you lengthen the bar about 1 to 2 inches, then probably

the shoes will stay on through the night.

Even if the heelcord is slightly tight, I would not do anything now

since he walks well. Another heelcord tenotomy can be done later on

in several months if necessary.

The foot is short and stubby and these feet are difficult to

maintain in the open toe lace up shoes often used on the bar. A

local craftsman, , makes a three strap sandal on a

molded plastic footplate on a bar which we have found to be

indispensable in maintaining the correction in these feet. If you

are interested in obtaining the brace, you can contact him

at mdsgns@... or call 319 653-7435.

If you go to the web site www.global-help.org and click on

Publications, you can download a copy of Clubfoot: Ponseti

Management which is very informative.

There is a good family support group at

http://groups.yahoo.com/group/nosurgery4clubfoot

I.V. Ponseti, M.D.

I figured his response would be such so I headed out this morning to

Gulfport to have his bar straightened before receiving this email.

No need to spread the shoes out, I know that his feet will stay in

the shoes with the bar straight. Tonight he'll be back in them and

into his usual routine.

Once we see a Dr in Hawaii, preferably Durkin, he can deal with

whether or not to perform another tenotomy. Im SO relieved to hear

that he's not relapsing.... I was, in no way, looking forward to

the battles w/ the military and Tricare that lie ahead had it been a

relapse.

Thanks to everyone for you support and advice,

Lori