STACEE - Clarification on shoes, please?

[Guest guest]

All Right Stacee - a quick lesson in all this brace stuff you asked.

FAB: Foot Abduction Brace...

DBB: Dennis Brown Bar

The FAB and DBB are the same thing(s) called by different names.

MITCHELL: " invented " a new style of FAB (DBB) a couple years ago.

It is still shoes on a bar, and works under the same principal as the old

styles, but yes, more comfortable for certain children and seems to be having

great results.

The MITCHELLs are sometimes called the P/M, for Ponseti/;

sometimes they're called sandals, cuz they look like summer shoes.

MARKELL: Sold by Jay Markell. Not sure how long these have been around bt it

seems like forever. These are the white open-toe boots on a bar.

There has been a few new varieties of the MARKELL lately too, such as

the infant size with an open heel area; new padding options, etc.

Both the MITCHELL and the MARKELL require a bar. However, the bar is NOT

interchangable between the two styles of shoes. For a Markell, you need

Markell's bar (try to get the red adjustable bar so you can keep it the right

size as yoru baby grows more easily and probably only need to purchase one

through out treatment) - for 's you need 's bar (it is

adjustable and you'll probably only need to buy one through the course of

treatment).

DOBBS: This is a new FAB system developed by Dr. Dobbs. Same principal as the

Markell and s but the bar is different - it is actually made to bend in

the middle (I have not seen one myself but a few folks here have it). This is a

another shoe/bar combination that has to work with Dobbs parts - the parts are

not interchangable with the other systems (ex. can't put a Markell shoe on a

Dobbs bar far as I know, etc.)

In short, which ever system you go with, you can't mix and match shoes and bars

between systems.

As others said, tons of people have had excellent results with all three styles

of shoe/FAB/DBB, but it does appear each system has their own customer base -

s' are geared more towards " trouble " feet. s cost considerably

more also - but if you kid can't tolerate the MARKELL shoe then the money is

worth it to avoid relapse. The Dobbs isn't widely used yet and is only

available through Dr. Dobbs I think...I don't know much about it.

When it comes to see Dr. Ponseti, all I can say is ask the old man anything you

want. Don't worry if it sounds stupid, he's a very generous and caring man

who'll take as much time as it takes with you and your child. He's 91 years old

- he's not in any hurry! haha

He can explain to you why he believes the FAB is better than an AFO for

example. Remember too that even though Ponseti is your 2nd opinion (key word:

Opinion) the University of Iowa has been the home to club foot research for over

half a century and does boast a 95% success rate because they have mastered the

technique and administer it in a pure fashion (i.e., no modifications).

There's just very few other clinics or doctors who are achieving this same

success because there are so many other clinics and doctors who don't perform

the method purely....they change it up to some degree which deminishes their

success rate.

I'll add here (long winded, I know) that the purpose of the FAB rather than the

AFO is that the bar on the FAB holds the feet at the 70 degree (over corrected)

angle and keeps the toes tilted up at 10 degrees to maintin the stretch in the

heels. As a primary source of maintainence the AFO (KAFO, etc.) just can't hold

it, so the foot eventually relapses.

With all that said, Let me confuse you with one more minor detail:

MITCHELL has started calling his FAB by the term AFO. UGH! We wish he

wouldn't but alas who are we to tell the guy what to call his invention? If you

hear the FAB referred to as the AFO it's really the FAB

(sandles on a bar).

I hope this helps you figure out which brace system will be best for your child.

If you do decide to go with a FAB system, rest assured the bar does NOT hinder

your child's development at all. They will reach all their mile stones on

target - roll, sit, crawl, walk, etc - provided there isn't another issue

working against them.

s.

Clarification on shoes, please?

I posted earlier about the Markell vs shoes... I think I understand

the difference

after looking at the website http://www.mdorthopaedics.com/index.htm, but I'm

not

positive...

If the doctor prescribes the Denis Brown Bar, can it be used with any of the

following:

AFO/KAFO, Markell Shoe, or Shoe? Which is recommended by the Ponseti

Method? Which does everyone here have experiences with?

From what I saw online, it appears that the shoe is a million times

comfier (is that

a word?!?) than the Markell shoe, so why would anyone not use it instead of

the Markell?

Does the Markell offer better end results than the ?

I'm trying to get as many questions lined up, answered, and ready for my f/u

to the ortho

on the 22nd. I just found out that our insurance covers some braces/shoes/DBB

but at a

very limited dollar amount, so I'm trying to get the ball rolling before this

calendar year is

over to take full advantage of the 2005 benefit. I need to have all my

ammunition ready

when I see the ortho again so I can make requests, if need be.

On that topic, I have set up an appt with Ponseti on Jan 6th, which is

hopefully right after

ds will be out of his casts, so I'm anxious to see what he says about our

story. What would

all of you do in our shoes? Would you make specific requests for treatment

(e.g. the

mitchell shoes vs the markell) of the current doc or not? I don't want to

second guess him,

but at the same time if there are better options available to us, I'd like to

use them!! I

couldn't get Dr Lemke's asst to answer ANY questions about my son without an

eval, which

of course we can't do until he's out of the cast... All I really wanted to

know is what course

she usually uses--the markell, AFO/KAFO, or mitchell, or other method of

bracing, but

they wouldn't answer me. Makes me leery of going to see her. I just don't

understand

why a doc would choose one method over another if the other is proven... Does

that make

sense? Keep in mind that I am fully aware that each case is different, but

overall the

treatments are very similar...

Thanks for listening!

Stacee