Re: AFO Bracing

[Guest guest]

Nan~ I am not the expert, but what DID type of Dr. Frick that he has neurogenic

clubfoot if he has not other signs? I ask this because my son has many other

issues, some including the brain, such as seizures. His cerebellum measured

small until he was born, he has a syrnix cavity in his spine, and currently his

white matter is not at age level, which could mean nothing. He recently got

smo's, which are lower than afo's. He got these to help him start walking, he

is 19 months, because he has weak ankles. Our PT and ortho. all say these will

be around for a year or two, and no one has mentioned the DBB going past the

normal time frame.

So, I guess what I am trying to say is how does he know at 6 months he will

always have to wear them. My son seems to have more signs than your little

one, and no one has said anything. His feet look great, and he wears the bar

about 10 hours a day with the smo's on all waking hours. I would stick with the

DBB until 4, the recommended time, then see a neurologist with any concerns

about neurogenic clubfoot, as there should be something they could pick up on,

but I wouldn't think an orthopedist would be the sole doctor to diagnose this.

KWIM? Plus, he seems a little young to be saying " the rest of his life. "

11/19/04

shyrod868 wrote:

Hi everyone,

My name is Nan and I am looking for some advice. I posted a message on

this site a few months back when my son was only 9 weeks old. I

received wonderful advice. My son is now 6 months old and has had the

tenotomy done 4 weeks ago. He is scheduled to wear his cast for 1

more week. At this time he will go in braces. His doctor is Dr.

Frick, Md from Charlotte, NC. He has stated all along that he

felt like my son, Jaiden, had neurogenic clubfeet. Meaning that he

will have to wear braces for the rest of his life. Is anyone familiar

with AFO bracing. I am a bit proplexed and overwhelmed with everything

that is going on. Dr. Frick says Jaiden's condition is very rare

because outside of the fact he has clubfeet there are no other

abnormalities that he can find that usually go along with neurogenic

clubfeet. Can anyone other any advice on the subject of neurogenic

clubfeet. I feel like I am rambling and not really getting across

what I am trying to say. I hope everyone understands what I am asking.

Your suggestion were so helpful before.

Thanks Alot

Nan

[Guest guest]

You aren't rambling Nan - any concern is a valid one here.

I am curious what markers Dr. Frick is using to conclude Jaiden has this rare

condition?

Like said, I wouldn't put the cart before the horse on all this yet.

I would seek an alternate opinion, though - perhaps more. See a specialist in

neurological disorders, and see another Ponseti clubfoot specialist.

Considering the thousands upon thousands of clubfeet Dr. Ponseti has had his

hands on over his long career I'd speak to Dr. Ponseti directly about it. He

may have some good insite to the situation for you to consider.

I am afraid you won't find many here who sing any praises for AFO's. They

certainly have their use in the world, but as a club foot treatment they are

most always a failure.

Does Dr. Frick want to use the AFO instead of the usual FAB (boots with bar used

after casting)? Or use an AFO in addition to a FAB? If he wanted to skip the

FAB and go straight in to the AFO after casting, I'd run.

I guess all I can offer to you here is that you should not only seek 2nd

professional opinions regarding both issues, but also devote a lot of effort in

to doing your own research about this rare condition that your son potentially

suffers.... which is what you've already begun to do, but keep looking further

than here. Try to find out more about it so you can help determine if in fact

your child has it, and if so, how to best treat it.

Wishing you the best of luck,

shawnee

Re: AFO Bracing

Nan~ I am not the expert, but what DID type of Dr. Frick that he has

neurogenic clubfoot if he has not other signs? I ask this because my son has

many other issues, some including the brain, such as seizures. His cerebellum

measured small until he was born, he has a syrnix cavity in his spine, and

currently his white matter is not at age level, which could mean nothing. He

recently got smo's, which are lower than afo's. He got these to help him start

walking, he is 19 months, because he has weak ankles. Our PT and ortho. all say

these will be around for a year or two, and no one has mentioned the DBB going

past the normal time frame.

So, I guess what I am trying to say is how does he know at 6 months he will

always have to wear them. My son seems to have more signs than your little one,

and no one has said anything. His feet look great, and he wears the bar about 10

hours a day with the smo's on all waking hours. I would stick with the DBB until

4, the recommended time, then see a neurologist with any concerns about

neurogenic clubfoot, as there should be something they could pick up on, but I

wouldn't think an orthopedist would be the sole doctor to diagnose this. KWIM?

Plus, he seems a little young to be saying " the rest of his life. "

11/19/04

shyrod868 wrote:

Hi everyone,

My name is Nan and I am looking for some advice. I posted a message on

this site a few months back when my son was only 9 weeks old. I

received wonderful advice. My son is now 6 months old and has had the

tenotomy done 4 weeks ago. He is scheduled to wear his cast for 1

more week. At this time he will go in braces. His doctor is Dr.

Frick, Md from Charlotte, NC. He has stated all along that he

felt like my son, Jaiden, had neurogenic clubfeet. Meaning that he

will have to wear braces for the rest of his life. Is anyone familiar

with AFO bracing. I am a bit proplexed and overwhelmed with everything

that is going on. Dr. Frick says Jaiden's condition is very rare

because outside of the fact he has clubfeet there are no other

abnormalities that he can find that usually go along with neurogenic

clubfeet. Can anyone other any advice on the subject of neurogenic

clubfeet. I feel like I am rambling and not really getting across

what I am trying to say. I hope everyone understands what I am asking.

Your suggestion were so helpful before.

Thanks Alot

Nan

[Guest guest]

Thanks guys for all of your support and suggestions. I am definitely

going to research more. Jaiden is otherwise a healthy child and is

developing normally and is a very active child. He started to be

cast at 3 weeks and he had serial cast for 6 weeks with little

improvement. It was very obvious that he was not cast properly for

several reasons. I believe because of his first cast that it

hindered and make his deformity worse. I think this is why Dr.

Frick believes he has neurogenic cf.

> Hi everyone,

>

> My name is Nan and I am looking for some advice. I posted a

message on

> this site a few months back when my son was only 9 weeks old. I

> received wonderful advice. My son is now 6 months old and has had

the

> tenotomy done 4 weeks ago. He is scheduled to wear his cast for 1

> more week. At this time he will go in braces. His doctor is Dr.

> Frick, Md from Charlotte, NC. He has stated all along that

he

> felt like my son, Jaiden, had neurogenic clubfeet. Meaning that he

> will have to wear braces for the rest of his life. Is anyone

familiar

> with AFO bracing. I am a bit proplexed and overwhelmed with

everything

> that is going on. Dr. Frick says Jaiden's condition is very rare

> because outside of the fact he has clubfeet there are no other

> abnormalities that he can find that usually go along with

neurogenic

> clubfeet. Can anyone other any advice on the subject of neurogenic

> clubfeet. I feel like I am rambling and not really getting across

> what I am trying to say. I hope everyone understands what I am

asking.

> Your suggestion were so helpful before.

>

> Thanks Alot

> Nan

>

>

>

>

>

>

>

[Guest guest]

I am not good with the website information, but I know lots of people on here

are, so hopefully they will give you some. The basic reason is that in Dr.

Ponseti's research he found the success rate drop during the use of AFO's

because the abduction of 70 degrees that the bar provides is not there. This is

important because it keeps the tendons and everything stretched while the child

is growing. If these things are not stretched then they are more likely to

relapse. I believe Dr. Ponseti, at one time, tried AFO's, but found what I

stated to be true; therefore, switched to the DBB. Hopefully, someone can give

you sites to look at. Sorry I couldn't help there.

11/19/04

shyrod868 wrote:

Hi its me again. I am wondering I was told that AFO bracing is not the

way to go with a child that has clubfeet from some of you. Can anyone

go in detail and tell me some reasons why they think AFO isn't good

for clubfeet. Please give me more websites to look at and read.

Thanks,

Nan

[Guest guest]

Hi Nan,

AFOs alone do not hold the outward abduction of the feet, which is why the shoes

attached to a bar are used for clubfeet after the initial casting. This holds

the feet in the correct position while the baby grows so the feet don't return

to their clubbed position. This explanation is a bit simplistic but hope it

helps.

Carol

AFO Bracing

Hi its me again. I am wondering I was told that AFO bracing is not the

way to go with a child that has clubfeet from some of you. Can anyone

go in detail and tell me some reasons why they think AFO isn't good

for clubfeet. Please give me more websites to look at and read.

Thanks,

Nan

[Guest guest]

Nan,

To clarify- some children do wear AFOs during the day time in addition

to their FAB at night. Some children have inherent weaknesses in

their legs/ankles and they benefit from extra support during the day.

Is this what Dr. Frick is recommending? I think most kids would also

wear the FAB at night, though, to help keep the foot abducted (rotated

outward) and dorsiflexed (toes pointed upward) to keep those tendons

and ligaments stretched.

Also, some children who have other conditions outside of clubfoot

(i.e. spina bifida) may wear AFOs instead of an FAB.

So there are always exceptions to the rule. But by and large, for

most kids who have just congenital clubfoot, they only need the FAB

for bracing.

I hope this helps!

>

> Hi its me again. I am wondering I was told that AFO bracing is not

the

> way to go with a child that has clubfeet from some of you. Can

anyone

> go in detail and tell me some reasons why they think AFO isn't good

> for clubfeet. Please give me more websites to look at and read.

>

> Thanks,

> Nan

>

[Guest guest]

well put, thanks

Re: AFO Bracing

Nan,

To clarify- some children do wear AFOs during the day time in addition

to their FAB at night. Some children have inherent weaknesses in

their legs/ankles and they benefit from extra support during the day.

Is this what Dr. Frick is recommending? I think most kids would also

wear the FAB at night, though, to help keep the foot abducted (rotated

outward) and dorsiflexed (toes pointed upward) to keep those tendons

and ligaments stretched.

Also, some children who have other conditions outside of clubfoot

(i.e. spina bifida) may wear AFOs instead of an FAB.

So there are always exceptions to the rule. But by and large, for

most kids who have just congenital clubfoot, they only need the FAB

for bracing.

I hope this helps!

>

> Hi its me again. I am wondering I was told that AFO bracing is not

the

> way to go with a child that has clubfeet from some of you. Can

anyone

> go in detail and tell me some reasons why they think AFO isn't good

> for clubfeet. Please give me more websites to look at and read.

>

> Thanks,

> Nan

>

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[Guest guest]

I just thought that I would add that I searched Pubmed and could not

find any articles including a combination of the search terms

" Ponseti, " and " AFO " or " Ankle Foot Orthosis " . Simply because AFO's

are not discussed in literature pertaining to the Ponseti Method.

I also thought this was kind of interesting so I'll share, not really

related to your question Nan, but I'm just anal this way.

I looked for a combination of " clubfoot " and " Ankle Foot Orthosis " . I

came up with 20 publications - the subjects of those publications were:

1 regarding neglected clubfoot

1 that was in German so I couldn't read it

3 regarding adults with on-going clubfoot issues

6 regarding surgical correction of clubfoot

9 regarding clubfoot in association with other conditions such as

arthrogryposis, cerebral palsy, strokes, etc.

I find this interesting that no one is writing papers about their

success using AFO's to hold correction in non-surgically corrected

clubfeet, but yet we hear about doctors prescribing them all the time.

Maybe they should practice what they preach?

> >

> > Hi its me again. I am wondering I was told that AFO bracing is not

> the

> > way to go with a child that has clubfeet from some of you. Can

> anyone

> > go in detail and tell me some reasons why they think AFO isn't good

> > for clubfeet. Please give me more websites to look at and read.

> >

> > Thanks,

> > Nan

> >

>