Needs advice/opinion regarding Achilles tendon

[Guest guest]

My Boy is 2 years old with bcf. Casting started after

a week and presently his both feet are corrected and

he is walking/running like a normal child. But during

a routine check this month his doctor says that his

left feet dorsiflexion is only 5 degee and needs to be

corrected. He adviced us to wait for 3 months and

concentrate on excercise and if after 3 months the

dorsiflexion not incresed upto the required level,

then it requires Achilles tendon lentghening. kindly

advice the surgery at this age group and especially

when child otherwise performs well.

SL

__________________________________________________

[Guest guest]

My son is 21 months and has never had a tenotomy (lengthening of the heel cord)

His dorselfextion is only 5 degrees. We see Dr. Ponseti and he also said the

same thing. Wait a couple of months and if it doesn't improve he will do the

tenotomy.

Tabitha

SHAHID LATIF wrote:

My Boy is 2 years old with bcf. Casting started after

a week and presently his both feet are corrected and

he is walking/running like a normal child. But during

a routine check this month his doctor says that his

left feet dorsiflexion is only 5 degee and needs to be

corrected. He adviced us to wait for 3 months and

concentrate on excercise and if after 3 months the

dorsiflexion not incresed upto the required level,

then it requires Achilles tendon lentghening. kindly

advice the surgery at this age group and especially

when child otherwise performs well.

SL

__________________________________________________

[Guest guest]

Thanks for sharing the Ponseti's advice. I request u

to please further share Ponseti's remarks whenever u

visit him next time for your son. It will be helpful

for me here in Pakistan to learn from your experience,

as u have access to Dr. Poseti.

If possible, kindly share some details i.e timing and

stretching per day on excercise suggested by Poseti.

Regards

SL

--- Yarolim wrote:

> My son is 21 months and has never had a tenotomy

> (lengthening of the heel cord) His dorselfextion is

> only 5 degrees. We see Dr. Ponseti and he also said

> the same thing. Wait a couple of months and if it

> doesn't improve he will do the tenotomy.

>

> Tabitha

>

> SHAHID LATIF wrote:

> My Boy is 2 years old with bcf. Casting started

> after

> a week and presently his both feet are corrected and

> he is walking/running like a normal child. But

> during

> a routine check this month his doctor says that his

> left feet dorsiflexion is only 5 degee and needs to

> be

> corrected. He adviced us to wait for 3 months and

> concentrate on excercise and if after 3 months the

> dorsiflexion not incresed upto the required level,

> then it requires Achilles tendon lentghening. kindly

> advice the surgery at this age group and especially

> when child otherwise performs well.

>

> SL

>

> __________________________________________________

>

[Guest guest]

Shahid,

Be sure to ask your doctor whether he means a tenotomy or a lengthening

surgery. They are two very different procedures, the tenotomy being much

less invasive. When our daughter was 4 years old her dorsiflexion was also

at 5°. She was too old for a tenotomy so Drs. Ponseti and Morcuende left it

as is.

Dan

Re: Needs advice/opinion regarding Achilles

tendon

My son is 21 months and has never had a tenotomy (lengthening of the heel

cord) His dorselfextion is only 5 degrees. We see Dr. Ponseti and he also

said the same thing. Wait a couple of months and if it doesn't improve he

will do the tenotomy.

Tabitha

SHAHID LATIF wrote:

My Boy is 2 years old with bcf. Casting started after

a week and presently his both feet are corrected and

he is walking/running like a normal child. But during

a routine check this month his doctor says that his

left feet dorsiflexion is only 5 degee and needs to be

corrected. He adviced us to wait for 3 months and

concentrate on excercise and if after 3 months the

dorsiflexion not incresed upto the required level,

then it requires Achilles tendon lentghening. kindly

advice the surgery at this age group and especially

when child otherwise performs well.

SL

__________________________________________________

[Guest guest]

Shahid,

My daughter is 6 and sees Dr. Ponseti. From what I understand, your

son will not be able to have the percutaneous tenotomy at this point

because he is too old. To lengthen his Achilles would require a

pretty invasive procedure involving the muscle in his calf.

My daughter has very little dorsiflexion on her clubfoot (she is

unilateral, left), but uses it just fine. She walks normally, runs,

uses stairs properly, and generally has no problems. Dr. Ponseti

has mentioned the possibility of a tendon lengthening for her in the

past when evaluating the tightness of her foot with his hands

(before he looks in her chart that is), but then, when he watches

her walk, he says that she uses it just fine and he will not subject

her to the lengthening unless the lack of dorsiflexion starts to

affect her gait etc.

Dr. Ponseti has told me the following story a number of times: in

the 70's when stilletto heels were popular here in the U.S., many

women (with normal feet, not clubfoot) actually had self-inflicted

shortening of their Achilles tendons due to wearing the high heels

all the time. He said that even though they had little

dorsiflexion, they still did not have any problems later in life.

I would recommend that as long as your son is using his feet

properly (look at the wear on the bottoms of his shoes to see if

they are wearing in the same areas at the same rate) and can use

stairs normally, to prolong the surgery. You can do the Achilles

lengthening at any time now, whether he's 2 or 12, but I wouldn't

consent to it unless there's a real problem that needs to be

addressed. Certainly you could email Dr. Ponseti and get his input

as well.

You can also use stretches to maintain the dorsiflexion that he

currently has and make sure that his brace has an adequate amount of

dorsiflexion on it to keep his tendons stretched when he's sleeping.

I hope this helps!

& (3-16-00, lcf, http://ponseticlubfoot.freeservers.com)

>

> My Boy is 2 years old with bcf. Casting started after

> a week and presently his both feet are corrected and

> he is walking/running like a normal child. But during

> a routine check this month his doctor says that his

> left feet dorsiflexion is only 5 degee and needs to be

> corrected. He adviced us to wait for 3 months and

> concentrate on excercise and if after 3 months the

> dorsiflexion not incresed upto the required level,

> then it requires Achilles tendon lentghening. kindly

> advice the surgery at this age group and especially

> when child otherwise performs well.

>

> SL

>

> __________________________________________________

>

[Guest guest]

I'm not sure what kind of exercises have been advised to stretch the heel, if

any, but I suggest riding toys of any variety but if possible especially those

you peddle, like a trike/bike. And if possible tease the child in to squatting

instead of sitting or bending over. Of course when he's on your lap relaxed you

can stretch the foot manually too.

s.

Re: Needs advice/opinion regarding Achilles

tendon

My son is 21 months and has never had a tenotomy (lengthening of the heel

cord) His dorselfextion is only 5 degrees. We see Dr. Ponseti and he also said

the same thing. Wait a couple of months and if it doesn't improve he will do

the tenotomy.

Tabitha

SHAHID LATIF wrote:

My Boy is 2 years old with bcf. Casting started after

a week and presently his both feet are corrected and

he is walking/running like a normal child. But during

a routine check this month his doctor says that his

left feet dorsiflexion is only 5 degee and needs to be

corrected. He adviced us to wait for 3 months and

concentrate on excercise and if after 3 months the

dorsiflexion not incresed upto the required level,

then it requires Achilles tendon lentghening. kindly

advice the surgery at this age group and especially

when child otherwise performs well.

SL

__________________________________________________