Re: changing the angle on the bar from 70 degrees to 60 degrees

[Guest guest]

Hi,

As far as decreasing to 18hr/d, that is likely just fine. Some do

20, and some drop right to 18. What you want to shoot for is to be

at 14-16 until walking age (12-14mo's on average) and then to 12-14

at or around that time. Later on, as I have heard from Dr. Morcuende

10-12 is fine for the long term, this is what he said we should be at

for my daughter who is going to be 3 in a month.

The abduction reduction however, I would distrust too unless there's

some reason (like loose ligaments - which isn't really diagnosable at

that young age) that 70 would be too much. There's not a lot of

reason to reduce, especially if he's happy at 70 so I'm not sure why

your doc would do that but I'd absolutely ask why *not* 70 and get a

detailed explanation of what the reasoning is. Simply being

*abducted enough* isn't a reason, that's what you want actually.

Changing the abduction on the shoes is easy, you can do it yourself

if you feel like it. There really should be no reason NOT to have

him at 70 degrees, and it won't hurt him if you did change it

back. Remember, there are no brace police out there so if you feel

more comfortable following Ponseti's protocols, go ahead. Just tell

the doc what you've done next time you go back lol. At least give

them that info and let him see it isn't causing any issues.

hth

Kori

At 02:10 PM 2/27/2006, you wrote:

>My son has now been out of the casts for 2 months and he has been

>wearing the bar and shoes 23/7. He has unilateral clubfoot. During

>our appointment last week, the doctor changed the angle on the

>clubfoot shoe from 70 degrees to 60 degrees because he indicated the

>foot was turned out enough. This appears to be contrary to Ponsetti

>protocol. Should I be concerned? Also, he indicated that at the end

>of 3 months in 23/7 we could go down to 18 hours in the shoes. Is

>this what Dr. Ponsetti is currently recommending?

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[Guest guest]

I second what Kori said about dropping to 18 hours. I am also a bit

leery of the reduction in angle although 60 degrees is not a huge

deal, I would question it. I can see a doc reducing the angle if the

child is older, say 2 1/2 or 3 or so and the foot is still very over

abducted, but I don't agree with reducing because he is " abducted

enough " , that just doesn't make any sense. Remember, what you want

here is to keep enough abduction to give the foot full range of

motion once it gradually moves back on it's own. I would ask the

doctor about it, just to try to get a clear answer. Like I said, I

don't think 60 degrees is a BIG red flag, but I would want some

clarification to his answer.

HTH,

> >My son has now been out of the casts for 2 months and he has been

> >wearing the bar and shoes 23/7. He has unilateral clubfoot.

During

> >our appointment last week, the doctor changed the angle on the

> >clubfoot shoe from 70 degrees to 60 degrees because he indicated

the

> >foot was turned out enough. This appears to be contrary to

Ponsetti

> >protocol. Should I be concerned? Also, he indicated that at the

end

> >of 3 months in 23/7 we could go down to 18 hours in the shoes. Is

> >this what Dr. Ponsetti is currently recommending?

> >

> >

> >

> >

> >

> >

> >