Re: new to the markells and brace

[Guest guest]

,

Thanks a heap for the advice.

I have attached some photos of Ethan with the bar up against his back (under

Ethan B in the folder). I think the boots are the correct width. You're

right about the left foot. I think the boot is too big. the orthotist

advised me that it is a 000 size, which is the smallest size. I was

wondering about trying a different boot type. The boots in the photo are

markells, but I notice there are a lot of comments on this site about

mitchells and other boots, that might be more appropriate.

I take the point about the 70 degrees and am looking in to it!

Comments/thoughts regarding the above are much appreciated.

Cheers

Colette

> Collette,

> The feet do look too close together to me. The easiest way to measure

> this is by holding the shoes up to his back, there's a picture of this

> in the tips document, you can download it from 's site here:

>

>

http://members.tripod.com/ponseti_links-ivil/sitebuildercontent/sitebuilderfiles\

/fab_tips_10_05_05.pdf

> The other problem is the degree of abduction. If Ethan's last cast

> was set at 45 degrees then that's where his shoes should be set at, so

> that part should not be causing him discomfort. I would most

> definitely ask Dr. Patel about that, I have heard that he is not fully

> abducting and I find it odd, considering all his training. What I

> learned when I went to the symposium in Iowa last year was that this

> degree of abduction is not only found to be the most successful for

> avoiding relapses (per Dr. Ponseti's studies), but it is also very

> important for creating a normal range of motion in the foot. If the

> foot is not fully abducted to 70 degrees then as it gradually drifts

> back over the next few years the child will lose flexibility and not

> be able to turn the foot as far out as a normal foot; i.e. The full

> range of motion of a normal foot is about 45-50 degrees so if you only

> abduct to 45 degrees to begin with, then as time passes the foot will

> lose some of that abduction, and may only be able to move out a few

> degrees if at all.

> The other thing I see in the photos is that either Ethan's left shoe

> is way too big or his heel is rising up. The right foot looks like

> his toes are right where they need to be, but on the left you can't

> even see his toes. Poorly fitting shoes will cause him to be

> uncomfortable, plus if he is slipping around in the shoe then he will

> get blisters, slip out of the shoes entirely and possibly lose

> correction. If his feet are two different sizes you need to make the

> orthotist split sizes and give you the correct size for both feet!

> I hope this helps, hang in there and we'll keep at it until we get

> Ethan comfortable. : )

>

>

> Mom to Jenna (4/7/01) & Sammy (9/25/04, RCF, Dobbs' brace, 14hrs/day)

>

>

>

>

>

> >

> > Hi

> >

> > Thanks for your response. I have taken 2 photos and placed them on

> the site

> > in the folder Ethan B. I think the inside heel is in line with the

> > shoulders. Initially the orthotist had it too wide, but I think it is ok

> > now. What do you think?

> >

> > Ethan's doctor is Dr Patel. The left foot is the club foot, however both

> > feet are at 45 degrees (as opposed to 70 degrees for the club foot).

> I need

> > to ask Dr Patel why it is not set at 70, but given that the casting only

> > went to 45 degrees I can't reset the brace. I think you're correct in

> > thinking that the problem is something to do with the brace, but I

> assume

> > that the 45 degrees would not create discomfort?

> >

> > Advice/comments appreciated

> > Colette

> >

>

>

>

>

>

>

>

>

[Guest guest]

Colette,

From what I am seeing in the photos the bar looks too short. Most

children seem to be most comfortable with the heels of the shoes even

with the outside edges of the shoulders. I took a picture of my

son's old brace (I had to use a doll, sorry for the unrealism), and

put in a folder called bar width so you can see what I mean. See how

the shoulders actually fit between the heels? Some kids are okay

with bolt to bolt being the same width as the shoulders but if Ethan

is still having problems tolerating them, I would definitely widen

them at least one hole on either side.

As for the shoe sizes, they do come in a 0000 which many orthotists

don't know but they can be ordered from Markell as per their website:

http://www.markellshoe.com/ponsetiflyer.pdf

Hope this helps, keep us posted!

> > >

> > > Hi

> > >

> > > Thanks for your response. I have taken 2 photos and placed them

on

> > the site

> > > in the folder Ethan B. I think the inside heel is in line with

the

> > > shoulders. Initially the orthotist had it too wide, but I think

it is ok

> > > now. What do you think?

> > >

> > > Ethan's doctor is Dr Patel. The left foot is the club foot,

however both

> > > feet are at 45 degrees (as opposed to 70 degrees for the club

foot).

> > I need

> > > to ask Dr Patel why it is not set at 70, but given that the

casting only

> > > went to 45 degrees I can't reset the brace. I think you're

correct in

> > > thinking that the problem is something to do with the brace,

but I

> > assume

> > > that the 45 degrees would not create discomfort?

> > >

> > > Advice/comments appreciated

> > > Colette

> > >

> >

> >

> >

> >

> >

> >

> >

> >