Re: Ponseti casts not at 90 degree angle - ??

[Guest guest]

,

Can you measure the angle with a protractor? If they are not quite

90, like say 75-80 degrees that might be okay, but the less the angle

the greater the chances of slipping. The other big thing that the

bend at the knee does is prevent the foot from rotating at the ankle

or knee inside the cast. If the foot rotates inside the cast you

will not get the desired correction with each cast. The angle will

affect how her legs lay in the casts. Again, the less they are bent,

the more likely you are to see them laying out to the sides like you

have seen in pictures.

In regards to your previous post about the doctor, I have not heard

of him. I would venture to guess that this angle issue is why it

takes him 6-8 casts instead of 3-4. It may be just inexperience but

if he is not bending the knee enough and is leaving the casts on for

two weeks I would be concerned that he just is not doing it quite

right and would consider talking to him about these variations and or

seeking a new doctor.

HTH,

>

> My one-month-old got her first set of Ponseti casts today. But,

her

> legs are not set at a 90 degree angle. They are slightly bent and

her

> legs are not set to lay open like I've seen in photos. Rather, her

> knees point straight up to the sky. I've read on Dr. Ponseti's

> website that the casts have to be set at the 90 degree angle for

the

> most effective results. I am concerned that this doctor " modifies "

> Dr. Ponseti's method.

>

> What are other parents' observations of their child's casts? Does

> anyone have knowledge of a more detailed explanation as to why the

> casts have to be set at 90 degree angle?

>

[Guest guest]

If the knee isn't bent 90 degrees, it's not a Ponseti Cast.

I think you may want to consider getting her to a Ponseti Doc. ASAP.

One of the reasons the cast is bent 90 degrees is that it is

necessary for keeping the cast on. Another reason is that this helps

stretch the Achilles tendon the best.

The first casts do not point the feet out, more rather down and still

towards the center. Over the next few weeks it will go towards the

outside, and lastly, up (toes up). Till then, it does not look like

that picture on Dr. Ponseti's website front page, that is a picture

of the very last cast at 70 degrees abduction.

however, they ALL will have the 90 degree bend at the knee, and

should be right up to the groin in length.

Can you tell us where you are so we can help you find another doc to

see for a second opinion? I would do this immediately, tomorrow if

possible. Any good Ponseti Doc will see you immediately, will not

make you wait. She shoud have this cast removed as soon as possible

if it indeed does not have any bend at the knee. She is better off

with a totally clubbed foot than with bad casting.

Can you send us a picture of this cast? Either send to me directly

(this list does not accept attachments) or subscribe to our pictures

list at http://health.groups.yahoo.com/group/CFPics/ and make sure

you read the attachment sent to the email addy that you subscribe

under. Then you can send pictures to the whole list in an email and

get everyone's input.

Let us know more about this cast, and where you are so we can help

you find a doc for a second opinion.

Kori

At 08:04 PM 2/7/2006, you wrote:

>My one-month-old got her first set of Ponseti casts today. But, her

>legs are not set at a 90 degree angle. They are slightly bent and her

>legs are not set to lay open like I've seen in photos. Rather, her

>knees point straight up to the sky. I've read on Dr. Ponseti's

>website that the casts have to be set at the 90 degree angle for the

>most effective results. I am concerned that this doctor " modifies "

>Dr. Ponseti's method.

>

>What are other parents' observations of their child's casts? Does

>anyone have knowledge of a more detailed explanation as to why the

>casts have to be set at 90 degree angle?

>

>

>

>

>

>

[Guest guest]

's local ortho who did the majority of her casts before we got our last

one from Dr. Ponseti did the knee bend at a bit less than 90 degrees. He used

fiberglass, as well, instead of plaster. We got pretty good results but he

modified the method enough that her feet were not abducted to 70 degrees until

Dr. Ponseti did the last cast, which would have caused problems in the shoes.

Her casts were not a lot less than 90 degrees but somewhat. I think you are

doing well to ask questions and get information. You can also ask the doc what

his thinking is since you have read that the Ponseti method protocol is 90

degree angle at the knee. A good doc will answer questions without being

threatened.

Carol and , 10-27-05, bcf, FAB 23/7

Ponseti casts not at 90 degree angle - ??

My one-month-old got her first set of Ponseti casts today. But, her

legs are not set at a 90 degree angle. They are slightly bent and her

legs are not set to lay open like I've seen in photos. Rather, her

knees point straight up to the sky. I've read on Dr. Ponseti's

website that the casts have to be set at the 90 degree angle for the

most effective results. I am concerned that this doctor " modifies "

Dr. Ponseti's method.

What are other parents' observations of their child's casts? Does

anyone have knowledge of a more detailed explanation as to why the

casts have to be set at 90 degree angle?