Dennis-Browne Splint

[Guest guest]

Please help!! I am a specialty nurse for a pediatric orthopaedic

surgeon who practices the Ponsetti method for clubfoot.

My parents are having a HORRIBLE time keeping the splint on. We use

the open toed Markell shoes. This isn't a new problem and we have

had

many recurrences due to lack of compliance, but I really want to help

my parents make the experience less stressful. Any hints or

suggestions on the braces?

[Guest guest]

There is a document on file that you could print out with several great tips on

it. Are the parents leaving the shoes are for 23 hours a day for 3 months like

they are suppose to? That could be a problem for some parents. Make sure the

bar is longer. We had our son's set shoulder width apart from the bolts, but he

would get leverage and pull out. Dr. Ponseti told us to make the bar shoulder

width from heel to heel if he kept pulling out. This has helped 100%.

jennifer

Dennis-Browne Splint

Please help!! I am a specialty nurse for a pediatric orthopaedic

surgeon who practices the Ponsetti method for clubfoot.

My parents are having a HORRIBLE time keeping the splint on. We use

the open toed Markell shoes. This isn't a new problem and we have

had

many recurrences due to lack of compliance, but I really want to help

my parents make the experience less stressful. Any hints or

suggestions on the braces?

[Guest guest]

Hi, and welcome,

We're glad you posted. It's always good to see caregivers here. It's

great that you are seeking a solution for your patients. I am the mom

of a 5 year old treated by Dr. Ponseti.

As I'm sure you know, it's vitally important to have the babies wear

the FAB (foot abduction brace) faithfully, or relapse will happen.

Here are some sources of info online:

The Global Health booklet on the Ponseti method. Its section on bracing

starts at pages 16.

http://www.global-help.org/publications/cf.2.pdf

Here is a tip sheet from the orthotists in Iowa:

http://members.tripod.com/ponseti_links-ivil/id12.html

I also urge you to consider getting in touch with Dr. Ponseti's office.

I am sure that he, his nurses and the orthotists there would be glad to

talk to you about this problem. They are very willing to help parents,

and I know they would want to help you help your patients.

You also might want to talk to them about the newer Ponseti/

brace, designed for those babies who for whatever reason have trouble

keeping the brace on.

Here is the contact information..

Telephone:

(319)356-3469

Address:

University of Iowa Hospitals and Clinics

200 Hawkins Drive

010255 JPP

Iowa City, IA 52242

Via E-mail:

ignacio-ponseti@...

In my experience as a member of these parent support groups for several

years now, if there is a persistent problem with the shoes staying on,

several things seem to routinely pop up as the reason. Here are some:

the feet were not fully corrected, or they have relapsed.

the last cast was not placed at a 70 degree angle, to match that of the

shoes.

there's a waiting period between when the last cast is removed and when

the babies get the brace, and the feet start to relapse.

the bar is too narrow.

the shoes are too big.

the straps have stretched and don't have enough holes punched in them.

sometimes extra padding (plastizode insert) is needed at the back of

the shoe.

If everything has been done and set up right, there really shouldn't be

a reason for the feet of the majority of patients to slip. If they do,

however, as I " m sure you're aware, relapsing becomes a problem, which

then makes it even more likely for the feet to slip, and it becomes a

vicious cycle.

I hope this is helpful and that you get some good information and

tips.. Please let us know how things go!

and Claire