Guest guest Posted August 22, 2005 Report Share Posted August 22, 2005 Very good point!!! The foot should come out of the last cast already at 70 degrees rotation! The FAB of course holds it there. s. ----- worked out to the 70 degrees in the last cast and the foot will already have been eased into the position. If they are not casting out to 70 degrees, then it probably would be traumatic for the child to wear the shoes at this angle. I personally would be skeptical of this as it seems to be a pretty important point that he is deviating on. Who is your Doctor and where do you live? Perhaps there is someone who will not deviate from the protocol close to you. Jenni --- alex_ronderos wrote: > Hi Everyone > > Just have question. Yesterday I met with the > potential doctor > (listed > in the virtual hospital website) for treatment for > my unborn baby's > right club foot. Everything seems OK except that he > varies from the > Ponseti procedure in regards to the abduction of the > Dennis Brown > Boots. Instead of 70 degrees for the affected foot, > he places the > foot at 45 degrees. His reasoning is that it is > less traumatic for > the baby and he has not seen a difference in the > results from 70 > degrees. For those parents who have or are going > through this, what > do you think? My husband thinks I am stressing > myself out for nothing. > > I appreciate any comments. > > > > > Jenni- Mom to (10/31/01) and Kelsey (11/7/03)happy girl in DBB nights only for left clubfoot. ____________________________________________________ Start your day with Yahoo! - make it your home page http://www.yahoo.com/r/hs Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 22, 2005 Report Share Posted August 22, 2005 Hi Everyone Just have question. Yesterday I met with the potential doctor (listed in the virtual hospital website) for treatment for my unborn baby's right club foot. Everything seems OK except that he varies from the Ponseti procedure in regards to the abduction of the Dennis Brown Boots. Instead of 70 degrees for the affected foot, he places the foot at 45 degrees. His reasoning is that it is less traumatic for the baby and he has not seen a difference in the results from 70 degrees. For those parents who have or are going through this, what do you think? My husband thinks I am stressing myself out for nothing. I appreciate any comments. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 22, 2005 Report Share Posted August 22, 2005 , The stress you are going through now, trying to sort all of this out before your baby is born, is stress you can save yourself later on. And it's not nothing, it's your baby's treatment. Good for you for being on top of this! I'm very wary of any doctor who is modifying the Ponseti protocol. It's a straightforward enough protocol that has been shown to work very well. It doesn't need to be messed with. Holding the corrected foot/feet in abduction--70 degrees of abduction--is a very important part of the protocol. Do you know whether this doctor gets the foot into that much abduction in the last few casts? If he doesn't, he is not fully correcting the foot. Correcting the foot consists (in part) in correcting it out to the maximum normal abduction. Which is 70 degrees for most feet. And holding it in that corrected position with the DBB/FAB will help prevent a relapse. When Dr Ponseti developped this method, he did not initially abduct the foot out so far. However, he realized he got better results when he began to hyper-abduct the feet. Do you know how long this doctor has been having his patients wear the FAB at 45 degrees? If you let us know where you are located, we can try to point you towards someone who is following the protocol exactly. Your baby is lucky to have a mom who is asking questions! We wish you all the best. Naomi The Family Naomi Hannah(02/21/01) Jonah(06/20/03, corrected bilateral clubfoot, FAB 14/7) alex_ronderos wrote: Hi Everyone Just have question. Yesterday I met with the potential doctor (listed in the virtual hospital website) for treatment for my unborn baby's right club foot. Everything seems OK except that he varies from the Ponseti procedure in regards to the abduction of the Dennis Brown Boots. Instead of 70 degrees for the affected foot, he places the foot at 45 degrees. His reasoning is that it is less traumatic for the baby and he has not seen a difference in the results from 70 degrees. For those parents who have or are going through this, what do you think? My husband thinks I am stressing myself out for nothing. I appreciate any comments. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 23, 2005 Report Share Posted August 23, 2005 I think you are right to strees. That is a huge difference. Dr. Ponseti overcorrects to prevent relapse and feels this is very necessary. Better to stress now instead of when your baby's foot is relapsing. Good luck in your decision. Do as much research about what Dr. Ponseti has found with this and then talk with your husband about it showing him the research then you and him together can make an informed decision that you feel confident about. Pam and (8-12-01) > Hi Everyone > > Just have question. Yesterday I met with the potential doctor > (listed > in the virtual hospital website) for treatment for my unborn baby's > right club foot. Everything seems OK except that he varies from the > Ponseti procedure in regards to the abduction of the Dennis Brown > Boots. Instead of 70 degrees for the affected foot, he places the > foot at 45 degrees. His reasoning is that it is less traumatic for > the baby and he has not seen a difference in the results from 70 > degrees. For those parents who have or are going through this, what > do you think? My husband thinks I am stressing myself out for nothing. > > I appreciate any comments. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 23, 2005 Report Share Posted August 23, 2005 If you experiment with your own foot a little bit you'll notice that when you point your toes at 70 dg with the foot tilted slightly upwards (there should be about a 10 degree upward tilt, also), you'll really feel the amount of stretch in your heel. That is the stretch the baby needs to maintain while he grows. Put at 45 dg you'll hardly feel the stretch. Good point ee...I never tried that. We experimented with the 45* for comfort and bar widths, but I never thought of doing the dorsiflexion too. I can really see why the kids need that now. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 23, 2005 Report Share Posted August 23, 2005 , I just corresponded with Dr. Morcuende (Dr. P's colleague) this morning about the paper that he is getting ready to present in a few weeks at an international clubfoot meeting in Istanbul. The paper details findings about relapsing among various U of Iowa patients treated with the Ponseti method. There were two control groups- one group had their feet rotated 45-50 degrees (the old standard) and the other group to the current standard of 70 degrees. The relapse rate was much higher in the first group. Hopefully once this paper is presented, all doctors will realize how important the 70 degree abduction is. Please insist that your doctor consult with the doctors in Iowa about the 70 degree abduction and if he will not concede to that standard- find your baby another doctor! Maybe your doctor has not seen the difference in his own patients in going from 70° to 45°, but Dr. Ponseti has- and I'm willing to bet that Dr. P has a much larger population of patients and many more years of data to base his findings on. This is why we stress the importance of finding doctors who are not deviating from the U of Iowa's protocol...I wish they would choose to learn from that group's experience instead of modifying standards on their own. I also agree with ee- if you're up for it, I would send a note to Dr. P reporting that this physician is setting patients' braces at the lesser degree of rotation to see what he says. The unfortunate thing about the " list " is that once a doctor is listed, there's no way to police them if they decide to start tweaking things on their own. Best wishes- and please keep us posted! Enjoy the rest of your pregnancy!!!!! & (3-16-00, left clubfoot) > Hi Everyone > > Just have question. Yesterday I met with the potential doctor > (listed > in the virtual hospital website) for treatment for my unborn baby's > right club foot. Everything seems OK except that he varies from the > Ponseti procedure in regards to the abduction of the Dennis Brown > Boots. Instead of 70 degrees for the affected foot, he places the > foot at 45 degrees. His reasoning is that it is less traumatic for > the baby and he has not seen a difference in the results from 70 > degrees. For those parents who have or are going through this, what > do you think? My husband thinks I am stressing myself out for nothing. > > I appreciate any comments. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2005 Report Share Posted August 24, 2005 the foot has to be @ 70 degrees...tell the dr that. if he still insists @ 45 degrees find another dr. Quote Link to comment Share on other sites More sharing options...
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