Re: angle question

[Guest guest]

Kaci,

I don't have any information about the angle of the DBB because I am new to

all of this as well! But I wanted to share about Dr. Ponseti. Our daughter

is only about a month older than your son and we were having some questions

about her doctor and his use of the Ponseti method. We decided to make the

trip to Iowa to see Dr. Ponseti about 3 weeks ago and it was the best

decision that we could have made both for the peace of mind that we received as

well

as a good report! I would highly encourage you to go to Iowa! You said

that you live in Michigan...we live in Northern Indiana and it really wasn't a

bad drive at all! It was so wonderful to finally feel like we had the

best and most accurate information about our daughter's foot! And to know

for

sure that her foot was fully corrected and that her shoe and bar were set

correctly! We were so impressed by Dr. Ponseti and his staff that we have

committed to return to Iowa every six months for the check of her feet! I am

not trying to pressure but I can identify with how you are feeling and I just

wanted to say that we don't regret our trip to Dr. Ponseti at all!

HTH,

and Mallory (11-21-05, rcf PM's 20/7)

[Guest guest]

Kaci,

Sorry I don't have a success story. Our first dr. only had Karter''s shoes

set at 35 degrees. and he relapsed four times in the first year. At 14 months

and another relapse we went to see Dr. Ponseti. He recasted and set the shoes

up right and we have not had a relapse since Sept. Which is very good for us.

I would be worried about moving the shoes to 60 if his foot is not corrected

to this point. It could hurt him I would think. Maybe someone else will

respond who knows more than I.

Good luck

Tabitha

Brittanie 6 years

Karter blcf 20 months

nokitty00 wrote:

I posted last week about my doubts that our doctor is really

following the Ponseti method even though he claims to. One of my

reasons for concern is that 's feet aren't abducted to 70

degrees (I hope I'm using the right terminology...I feel pretty dumb

about all this around this group!). After posting on CFPics and

getting some feedback, my husband and I took 's bar apart

this weekend to put his feet shoulder-width apart and we rotated the

angle to about 60. We were afraid to go to 70 because when we

measured it, it was only around 35. We decided to move it to 60 and

see how he reacts, then we will change it to 70.

I spoke with the casting tech at our ortho's office today to discuss

the changes we made and she said they base the angle on the child's

severity and that they have had great success doing it this way. I

am not sure this is acceptable and would like opinions...do you know

of success stories with using a lower angle?

I also asked last week about doctors in Michigan - I think we will

probably see Dr. in Grand Rapids for his opinion, but we are

still thinking it might be better to go to Iowa City.

Thanks,

Kaci (mom to , 12/17/05, bcf, DBB 23/7)

[Guest guest]

Kaci,

I second Tabitha's concern about rotating 's feet without

having them first casted at that outward abduction angle. To jump

from 35° to 60° is a big step, so please be careful. I definitely

wouldn't try to go out to 70° unless casted at that angle first.

As far as the information on the correct abduction angle, here's a

link to the recent study about the long term affect the abduction

angle has on relapse: http://members.tripod.com/ponseti_links-

ivil/sitebuildercontent/sitebuilderfiles/clubfootrelapseabstract.pdf

The angles compared here are 70° for maximum abduction to 45° (I

believe) in the not-maximum abduction group. This should be enough

information for you to discuss with your ortho group to review and

compare the impact of their 35° protocol. Did they tell you how

long they'd been doing it this way and how old their oldest patients

were that had the minimal abduction bracing?

I hope this helps some!

& (3-16-00, lcf)

>

> I posted last week about my doubts that our doctor is really

> following the Ponseti method even though he claims to. One of my

> reasons for concern is that 's feet aren't abducted to 70

> degrees (I hope I'm using the right terminology...I feel pretty

dumb

> about all this around this group!). After posting on CFPics and

> getting some feedback, my husband and I took 's bar apart

> this weekend to put his feet shoulder-width apart and we rotated

the

> angle to about 60. We were afraid to go to 70 because when we

> measured it, it was only around 35. We decided to move it to 60

and

> see how he reacts, then we will change it to 70.

>

> I spoke with the casting tech at our ortho's office today to

discuss

> the changes we made and she said they base the angle on the

child's

> severity and that they have had great success doing it this way.

I

> am not sure this is acceptable and would like opinions...do you

know

> of success stories with using a lower angle?

>

> I also asked last week about doctors in Michigan - I think we will

> probably see Dr. in Grand Rapids for his opinion, but we are

> still thinking it might be better to go to Iowa City.

>

> Thanks,

> Kaci (mom to , 12/17/05, bcf, DBB 23/7)

>

[Guest guest]

Kaci,

Just as an addition to what said here -- Do you have 's

last cast? I don't remember if you mentioned if he was actually

casted with more abduction than what the shoes were set to. If you

have the cast you can measure the angle and see. If he was casted out

to 60 or more, then it would probably be fine to set the shoes to that

angle.

As for bracing angle relating to severity that is basically just

gambling on whether or not the child will have a relapse. The foot

always (well, almost always, loose ligaments is a whole other story)

has a tendency to turn back in a bit (thus the reason that you don't

see the older kids who've been corrected this way walking around with

their feet splayed out at 70 degrees), and that, along with obtaining

full range of motion is the reason for abducting to 70 degrees - and

there is a range that's acceptable, my son's brace is set at 65

degrees which doesn't concern me, but 35 would definitely concern me!

There is no way to know which child will relapse and which one won't,

it is not related to severity. Some of the more experienced docs can

tell early on if they think the child might need the ATTT when they

get older, but mild cases can and do relapse just as easily as a

severe one. And having the foot only turned out to 35 means there's

all the more chance that a slight regression of the foot would put it

back into adduction, whereas a slight regression in a foot that is at

70 will only lead the foot back to a more neutral position as is

natural as the child grows.

Hope this helps,

> >

> > I posted last week about my doubts that our doctor is really

> > following the Ponseti method even though he claims to. One of my

> > reasons for concern is that 's feet aren't abducted to 70

> > degrees (I hope I'm using the right terminology...I feel pretty

> dumb

> > about all this around this group!). After posting on CFPics and

> > getting some feedback, my husband and I took 's bar apart

> > this weekend to put his feet shoulder-width apart and we rotated

> the

> > angle to about 60. We were afraid to go to 70 because when we

> > measured it, it was only around 35. We decided to move it to 60

> and

> > see how he reacts, then we will change it to 70.

> >

> > I spoke with the casting tech at our ortho's office today to

> discuss

> > the changes we made and she said they base the angle on the

> child's

> > severity and that they have had great success doing it this way.

> I

> > am not sure this is acceptable and would like opinions...do you

> know

> > of success stories with using a lower angle?

> >

> > I also asked last week about doctors in Michigan - I think we will

> > probably see Dr. in Grand Rapids for his opinion, but we are

> > still thinking it might be better to go to Iowa City.

> >

> > Thanks,

> > Kaci (mom to , 12/17/05, bcf, DBB 23/7)

> >

>

[Guest guest]

To me it sounds like if he's doing a Ponseti method, it's a Modified Ponseti

Method because the bar should have been shoulder width from the start (and

continue to adjust to keep it shoulder width as he grows) and the feet should

have been casted to 70 degrees, then the FAB set at 70 degrees also. (except

shoes are usually at 60 for other reasons)

Modified Poneti's don't count in my book.

I would be getting a 2nd qualified opinion asap simply because you are fairly

close to Iowa City so it's possible, and if you catch any flaws early they can

be easily corrected before permanent damage is done.

I'd be careful moving the feet out from the 35 to 70 degrees, it could really

hurt at this point. Another thing is that if they feet weren't casted to this

position anyway, you can't be sure they were casted right at all to begin with.

They may look right on the outside but it's the way the bones are set on the

inside that matters, kwim?

s.

angle question

I posted last week about my doubts that our doctor is really

following the Ponseti method even though he claims to. One of my

reasons for concern is that 's feet aren't abducted to 70

degrees (I hope I'm using the right terminology...I feel pretty dumb

about all this around this group!). After posting on CFPics and

getting some feedback, my husband and I took 's bar apart

this weekend to put his feet shoulder-width apart and we rotated the

angle to about 60. We were afraid to go to 70 because when we

measured it, it was only around 35. We decided to move it to 60 and

see how he reacts, then we will change it to 70.

I spoke with the casting tech at our ortho's office today to discuss

the changes we made and she said they base the angle on the child's

severity and that they have had great success doing it this way. I

am not sure this is acceptable and would like opinions...do you know

of success stories with using a lower angle?

I also asked last week about doctors in Michigan - I think we will

probably see Dr. in Grand Rapids for his opinion, but we are

still thinking it might be better to go to Iowa City.

Thanks,

Kaci (mom to , 12/17/05, bcf, DBB 23/7)

[Guest guest]

To echo what others have said, don't be " afraid " to go to Iowa to see Dr.

Ponseti. My daughter (2 1/2 months old at the time) and I made it there all

the way from Texas, taking two different Angel Flights both up there and back

and staying 2 nights at the Mc house. It was such a worthwhile

trip.

Although I love our local ortho and he will be able to follow her for relapse

from here on out, he had not abducted my daughter's feet to the correct angle

(less than 70 degrees) with the last cast, which is not " fully corrected " per

the Ponseti method. So we got another cast in Iowa, which took care of the

issue and she was able to go directly into the shoes from there. There is no

one better to advise you about your baby than Dr. Ponseti and his staff. I felt

so wonderful about going, even though it was an exhausting trip.

Carol and , bcf, 10-27-05, s 18/7

angle question

I posted last week about my doubts that our doctor is really

following the Ponseti method even though he claims to. One of my

reasons for concern is that 's feet aren't abducted to 70

degrees (I hope I'm using the right terminology...I feel pretty dumb

about all this around this group!). After posting on CFPics and

getting some feedback, my husband and I took 's bar apart

this weekend to put his feet shoulder-width apart and we rotated the

angle to about 60. We were afraid to go to 70 because when we

measured it, it was only around 35. We decided to move it to 60 and

see how he reacts, then we will change it to 70.

I spoke with the casting tech at our ortho's office today to discuss

the changes we made and she said they base the angle on the child's

severity and that they have had great success doing it this way. I

am not sure this is acceptable and would like opinions...do you know

of success stories with using a lower angle?

I also asked last week about doctors in Michigan - I think we will

probably see Dr. in Grand Rapids for his opinion, but we are

still thinking it might be better to go to Iowa City.

Thanks,

Kaci (mom to , 12/17/05, bcf, DBB 23/7)

[Guest guest]

After reading some of the replies, I realized I probably misspoke.

We do not have his last set of casts (unfortunately I only learned

after he got them off that it is good to save them) but I thought

they were at a higher angle than his brace. I went back and looked

at some pictures and there is a huge difference - I cannot tell

exactly but I believe they were at (or close to) 70 degrees. So far

we have not had any sores and has not 'complained' about the

change in degrees...do you all think it is ok to leave them at this

angle or should I turn them back in until we are able to see another

doctor?

Thanks,

Kaci

>

> I posted last week about my doubts that our doctor is really

> following the Ponseti method even though he claims to. One of my

> reasons for concern is that 's feet aren't abducted to 70

> degrees (I hope I'm using the right terminology...I feel pretty

dumb

> about all this around this group!). After posting on CFPics and

> getting some feedback, my husband and I took 's bar apart

> this weekend to put his feet shoulder-width apart and we rotated

the

> angle to about 60. We were afraid to go to 70 because when we

> measured it, it was only around 35. We decided to move it to 60

and

> see how he reacts, then we will change it to 70.

>

> I spoke with the casting tech at our ortho's office today to

discuss

> the changes we made and she said they base the angle on the

child's

> severity and that they have had great success doing it this way.

I

> am not sure this is acceptable and would like opinions...do you

know

> of success stories with using a lower angle?

>

> I also asked last week about doctors in Michigan - I think we will

> probably see Dr. in Grand Rapids for his opinion, but we are

> still thinking it might be better to go to Iowa City.

>

> Thanks,

> Kaci (mom to , 12/17/05, bcf, DBB 23/7)

>

[Guest guest]

Kaci,

Sorry I didn't get back with you sooner - I've been away from my

computer for a few days.

I hate to answer this definitively since I'm not a medical

professional but I would agree that if you believe his last cast was

turned out to the correct degree and he is not complaining about the

increase with the angle of the shoes I would think it is probably okay

to leave them as you have them set now.

> >

> > I posted last week about my doubts that our doctor is really

> > following the Ponseti method even though he claims to. One of my

> > reasons for concern is that 's feet aren't abducted to 70

> > degrees (I hope I'm using the right terminology...I feel pretty

> dumb

> > about all this around this group!). After posting on CFPics and

> > getting some feedback, my husband and I took 's bar apart

> > this weekend to put his feet shoulder-width apart and we rotated

> the

> > angle to about 60. We were afraid to go to 70 because when we

> > measured it, it was only around 35. We decided to move it to 60

> and

> > see how he reacts, then we will change it to 70.

> >

> > I spoke with the casting tech at our ortho's office today to

> discuss

> > the changes we made and she said they base the angle on the

> child's

> > severity and that they have had great success doing it this way.

> I

> > am not sure this is acceptable and would like opinions...do you

> know

> > of success stories with using a lower angle?

> >

> > I also asked last week about doctors in Michigan - I think we will

> > probably see Dr. in Grand Rapids for his opinion, but we are

> > still thinking it might be better to go to Iowa City.

> >

> > Thanks,

> > Kaci (mom to , 12/17/05, bcf, DBB 23/7)

> >

>