Re: Question about degrees

[Guest guest]

Hi there,

yes, sounds like your doctor has waivered from the true Ponseti Method but

perhaps all is well that will end well.

I am very concerned though about the 24/7 wear " until he walks " . The child

won't learn to walk wearing the brace that long, will he? It really isn't

necessary to wear the brace that many hours for that many months - a gradual

reduction of hours is the norm allowing the child time to learn how to walk

normally with out the brace.

Dr. Ponseti is now recommending brace wear until the approx. age of 4 years.

Since most babies walk around the one year of age range, two years past that

would be 3 years (+ / - ). But you can cross that bridge when you get to it.

s.

Question about degrees

My grandson Bo is in the DB brace. The Dr. said his clubfoot (on

his right leg) was as mild as it could possibly be and should be

easily treated. He was casted from 5 days old and had his tendon

cut at three weeks. He got his last cast off last Tuesday and has

now been in the brace from that day on. We went to the

Brace Company and they fitted him right there. He is now set at 60

degrees. My daughter-in-law is a Dr. and she says her Orthopedic

surgeron, Dr. Lawrence Haber, says that this is as far as the

degrees will have to go. He is highly recommended here and in fact

had two club feet as a baby and is passionate about the subject.

From what I am reading on here the bar should eventually be set to

70 degrees? Is this correct?

My understanding is that Dr. Haber studied under Dr. Ponsetti. From

what I am reading here though, he is using a modified form of

treatment. He says that Bo will be in the brace 24/7 until he

walks. He has actually told and that the baby can be

out of the brace for 4 hours a day but they have not done so. We

have only let him out of it for bath time and a little play time

after bath. After Bo walks Dr. Haber says he will only have to wear

the brace at night for two years.

The treatment in the cast went much faster than expected. We were

not expecting the tendon surgery until he was around six weeks old

but Dr. Haber was very pleased to see his foot move to were he

wanted it in a much shorter time.

Comments on my statements above and also help with getting the brace

on right every time would be helpful. We have found that Bo's foot

will slip in it every once in a while. I went back to the brace

company and they showed me how to do it again. They said the person

who put it on for me the first time must have been afraid of hurting

the baby and that he did not have it on tight enough. I had him

mark everything with ink on the shoe and we have fared much better

since then but we have ocassionaly seen his foot slip back from the

line the orthotist drew on the shoe, which the orthotist said would

mean that his heel was slipping up out of place and that the shoe

would need to be put back on.

I have read the DBB tip file that was sent me and I found it helpful

but this is all a challenge and any help is appreciated.

[Guest guest]

I'm not familiar with Dr. Haber, and although I don't see his name on

the qualified physician's list (unless I'm just missing it), I see

what I would consider some " pink " flags here (i.e. not worrisome

enough to qualify as red flags if you are aware of them).

Per the protocol the last cast and thus the shoes should be set at 70

degrees, but I think that 60 is probably fine. The reason for the

over-abduction is to lessen the chances of relapse as the foot

gradually moves back to a straight position on it's own, and to give

the child normal range of motion.

The usual protocol for reduction in hours in the brace goes something

like this:

23/7 (1 hour out of the brace) for 3 months

Then gradually reduce, i.e. 20-22 hours for a while, then 16-18, and

then down to 12-14 around the time the baby starts walking or is about

1 year old. Some people go down to 10-12 hours (nights only) when the

child is a bit older (maybe 2 1/2 or 3?)

It is being recommended that the child wear the brace at an absolute

minimum until they are 3 1/2 and it is more common now that children

are staying in the brace until 4 or 5 years old just to avoid the

possibility of relapse.

Unfortunately I don't have a lot of time right now but I'm sure Kori

or someone else will jump in here with the comments on how to get the

shoes on nice and tight.

Gotta run, hope this was helpful,

Mom to Jenna (4/7/01) & Sammy (9/25/04, RCF, Dobbs' brace, 12-14hrs/day)

>

> My grandson Bo is in the DB brace. The Dr. said his clubfoot (on

> his right leg) was as mild as it could possibly be and should be

> easily treated. He was casted from 5 days old and had his tendon

> cut at three weeks. He got his last cast off last Tuesday and has

> now been in the brace from that day on. We went to the

> Brace Company and they fitted him right there. He is now set at 60

> degrees. My daughter-in-law is a Dr. and she says her Orthopedic

> surgeron, Dr. Lawrence Haber, says that this is as far as the

> degrees will have to go. He is highly recommended here and in fact

> had two club feet as a baby and is passionate about the subject.

> From what I am reading on here the bar should eventually be set to

> 70 degrees? Is this correct?

>

> My understanding is that Dr. Haber studied under Dr. Ponsetti. From

> what I am reading here though, he is using a modified form of

> treatment. He says that Bo will be in the brace 24/7 until he

> walks. He has actually told and that the baby can be

> out of the brace for 4 hours a day but they have not done so. We

> have only let him out of it for bath time and a little play time

> after bath. After Bo walks Dr. Haber says he will only have to wear

> the brace at night for two years.

>

> The treatment in the cast went much faster than expected. We were

> not expecting the tendon surgery until he was around six weeks old

> but Dr. Haber was very pleased to see his foot move to were he

> wanted it in a much shorter time.

>

> Comments on my statements above and also help with getting the brace

> on right every time would be helpful. We have found that Bo's foot

> will slip in it every once in a while. I went back to the brace

> company and they showed me how to do it again. They said the person

> who put it on for me the first time must have been afraid of hurting

> the baby and that he did not have it on tight enough. I had him

> mark everything with ink on the shoe and we have fared much better

> since then but we have ocassionaly seen his foot slip back from the

> line the orthotist drew on the shoe, which the orthotist said would

> mean that his heel was slipping up out of place and that the shoe

> would need to be put back on.

>

> I have read the DBB tip file that was sent me and I found it helpful

> but this is all a challenge and any help is appreciated.

>