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Re: About the DBB splintt

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HI-

Congratulations and welcome to the group. A suggestion for the fab-

hopefully though, maybe our Australian friends will pipe in as to

how they get the brace-would be to use the Ponseti brace.

http://www.mdorthopaedics.com/

Is the website for this brace. Its a newer model of the FAB-you can

read about it on the website. Also-with the DBB version of the fab-

maybe you can contact the Markell company directly and see if they

can help you.

These are just a couple of ideas!

kathleen

mom to fab 12/7

>

> Hi,everyone,I am a new member. It is great to know that there are

> parents who are willing to support each other in this way. I am

from

> China so my English may not be good enough. Forgive me. We have

our

> baby Isaac born with clubfeet on july 27 2005. We went to a

orthopeadic

> doctor in Taiwan and had 4 times of weekly changed plaster

casts.After

> that,we came back to China and stopped treatment for a month.Now

we

> restarted our trentment again in Bangkok (Thailand). Our doctor is

a

> qualified one on Ponseti method. But our problem is that our

doctor

> said that there is no good Denis Brown Splint manufacturer in

Thailand.

> We are worried about how we could solve this problem. Next Tuesday

our

> son is gonna have Achilles tendon cut,then three or four weeks of

final

> cast. Before that, we have to have his special shoes ready.

So,does

> anyone have good idea about what we should do? We greatly

appriciate

> any advices and comfort.

>

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Welcome to our group! Your English is very good! Don't worry about

it at all! In addition to the information that Kathleen gave you,

there is a distributor for the Markell shoes in the UK called

Kettering Surgical, there is also a brace manufacturer in Germany.

I don't know if either of these options will help you.

There is information about those companies on this website:

http://members.tripod.com/ponseti_links-ivil under the bracing

section.

You could also potentially contact the orthotists who work with Dr.

Ponseti in Iowa, USA, for the standard FAB with Markell open-toed

Tarso shoes and maybe they could send one to you. That company is

American Prosthetics and Orthotics. Telephone .

I know that would be willing to work with you to have

a brace made for your son, but they are specially made and it would

probably take a while for you to obtain the brace. Typically he

would send you a kit to make an impression of the feet and then you

send it back for him to make the brace. So maybe one of these other

options would be a good first start so that you can get a brace

quicker.

In case of delays, you can have your doctor in Thailand apply a cast

or two just to hold your son's feet in the corrected position until

the brace arrives and you're confident that it is set up correctly.

You won't want to leave his feet uncasted because they might turn

back in and then the brace will be uncomfortable for him.

I hope this helps!

Please ask any questions!

Regards,

& (3-16-00, lcf)

>

>

> >

> > Hi,everyone,I am a new member. It is great to know that there

are

> > parents who are willing to support each other in this way. I am

> from

> > China so my English may not be good enough. Forgive me. We have

> our

> > baby Isaac born with clubfeet on july 27 2005. We went to a

> orthopeadic

> > doctor in Taiwan and had 4 times of weekly changed plaster

> casts.After

> > that,we came back to China and stopped treatment for a month.Now

> we

> > restarted our trentment again in Bangkok (Thailand). Our doctor

is

> a

> > qualified one on Ponseti method. But our problem is that our

> doctor

> > said that there is no good Denis Brown Splint manufacturer in

> Thailand.

> > We are worried about how we could solve this problem. Next

Tuesday

> our

> > son is gonna have Achilles tendon cut,then three or four weeks

of

> final

> > cast. Before that, we have to have his special shoes ready.

> So,does

> > anyone have good idea about what we should do? We greatly

> appriciate

> > any advices and comfort.

> >

>

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Thanks,, and Kathleen

That's very kind of you to answer my questions and offer us some

options. When we first came to see Dr. Amnuay, I clearly remembered

that he said that his patients seldom use the brace due to the

lacking of good brace maker whom he trusted in Thailand. Instead, he

suggested to apply three weekly casting twice after the tenotomy. At

first we are happy about this because that would spare our baby and

us two to three years of hard time of wearing the brace.

Coincidently on our flight to Phuket island we bumped into a

stewardess whose son had bilateral clubfoot and was treated by

Dr.Amnuay as well. She said that her 3 or 4 years old son was

capable of doing everything but his feet twisted a little bit inward

or something (I didn't get it because of her Thai accent). So we

made up our mind to get our son the brace. We still trust our doctor

and as matter of fact we do not have other better choice. This

Tuesday Dr. Amnuay brought a young gentleman along and he measured

our son's feet. Although he did not do as professional as the

orthotists who work with Dr. Ponseti, we thought he did a good job

comparing to our previous experience. Hopfully we will see the shoes

without bar next Tuesday when our little guy go for his tenotomy

(the funny thing is that I had Achilles tendon rapture from soccor

game before). But I will try to get him a pair of magic boots

perfectly fit him so thanks for all the useful information. By the

way, would you be so kind to give us a general idea how much we are

giong to pay for the brace? Our Dr.is going to do the tenotomy

under general anesthesia and he explained that the most important

last casting could be applied to hold my son's feet on proper

position while he is sleeping. I think that makes sense. Usually our

doctor would prescribe a medicine called chloral hydrate to make

Isaac asleep before doing the manipunation and casts. We are going

to pay for that operation 1000 USD. Since we do not have insurance,

we are concerned about the budget. We do hope all of the things are

going to be well done and we can get back to home soon.

Warmly,

and Melody

> > >

> > > Hi,everyone,I am a new member. It is great to know that there

> are

> > > parents who are willing to support each other in this way. I

am

> > from

> > > China so my English may not be good enough. Forgive me. We

have

> > our

> > > baby Isaac born with clubfeet on july 27 2005. We went to a

> > orthopeadic

> > > doctor in Taiwan and had 4 times of weekly changed plaster

> > casts.After

> > > that,we came back to China and stopped treatment for a

month.Now

> > we

> > > restarted our trentment again in Bangkok (Thailand). Our

doctor

> is

> > a

> > > qualified one on Ponseti method. But our problem is that our

> > doctor

> > > said that there is no good Denis Brown Splint manufacturer in

> > Thailand.

> > > We are worried about how we could solve this problem. Next

> Tuesday

> > our

> > > son is gonna have Achilles tendon cut,then three or four weeks

> of

> > final

> > > cast. Before that, we have to have his special shoes ready.

> > So,does

> > > anyone have good idea about what we should do? We greatly

> > appriciate

> > > any advices and comfort.

> > >

> >

>

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& Melody,

I'm sorry that I cannot give you any estimates for getting the

brace. It's been a very long time since I've had to purchase any of

that equipment and I also don't know what the shoes cost.

Perhaps you could give the information about the German brace

manufacturer to your doctor. There are quite a few Australian

families who use the Ponseti method, you would think that perhaps

there is a manufacturer or distributor there also that would be able

to supply your doctor with the equipment. I'm kind of surprised

that your doctor hasn't tried to communicate with other doctors in

the region using the method, or Dr. Ponseti himself in order to try

to come up with a bracing solution. Even the remote villages in the

African countries have come up with some basic braces for the babies

there. I hope he is able to get that resolved soon!

The bracing is essential to prevent relapse. It's good that you're

determined to get this for your son. Using the brace is not a

challenge if the foot/feet are completely corrected and the brace is

fitted properly. My daughter didn't fuss once with her brace even

though she didn't even start wearing it until she was over 5 months

old. There is information on brace wear and relapse rates on this

website: http://members.tripod.com/ponseti_links-ivil under the

bracing section, the medical journals section, and the messageboard

posts section. The Global HELP booklet will be a good resource for

you (you can find the link to that under the medical journals

section as well).

You will want your son to wear the brace at night at least until age

3 and up to age 4 or 5 if he tolerates it. This is the best

insurance against relapse.

The key is to make sure that the inside edges of the heels of the

shoes are at a distance equal to the width of Isaac's shoulders.

Also to make sure that the feet are flexed upward (dorsiflexion) to

keep the Achilles tendon stretched.

I hope this helps some.

Regards,

& (3-16-00, left clubfoot)

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