Guest guest Posted May 22, 2006 Report Share Posted May 22, 2006 Hi Zoe. My 6-month old son (LCF) also has a shorter big toe on his clubfoot than on his non clubfoot. I've never been told that it was problematic. I also did not notice that the ball of that foot was lower, but then again, I never really looked at it in detail. Our doctor never mentioned it and I've sent numerous pictures of my son's feet to Dr. Ponseti and nothing was ever mentioned regarding the toe (I never brought it up either). When my little guy wakes up and after I take off his brace, I will check the ball of the foot just so I can see for myself. I always thought the short big toe was related to the clubfoot - like it was smooshed in and never had a chance to really fully grow. His foot was on the more severe side of the spectrum as well. I can send pictures of his foot if you would like for comparison. theresazoe1 wrote: Hi all, My 10 mo. old BCF dtr Sophie had a checkup w/ Dr Frick in Charlotte this past week. She is on the more severe end of the spectrum esp her left foot. I dont think she has " atypical/complex " but Im not 100% sure. (He said he doesnt classify feet that way ?) She has had 2 tenotomies and is in the p/m's 14/7. Anyway, he said her feet look good but two things we should keep our eye on: Her left foot has lost some dorsiflexion, you can feel how tight the achilles tendon has become again. You can get it to neutral but not much beyond. He said we can try to stretch it out a couple of times a day and the flexibility could improve as she grows and starts walking (does this sound right?) but otherwise she will need another tenotomy just on that foot. The other issue he pointed out is she has a short big toe relative to her other toes. I have noticed this before...the ball of her foot is further down (toward the middle of her foot)than it should be. He said this is unrelated to clubfoot. Also, it could become less pronounced as her bones grow. He is going to x-ray her in 3 months and see how it looks at that point. Apparently you usually see this short metatarsal in the fourth toe, not the big one. If left uncorrected it can cause discomfort and pain, and some difficulty walking etc. There is surgery to lengthen the bone, which he said is somewhat complicated. I didnt ask if this was something he had experience with or whether he would recommend us to someone else. I know Dr. Herzenberg is a specialist in limb lengthening; I dont know if this qualifies as that. My question is, has anyone encountered this short metatarsal problem along with clubfoot? I am trying not to dwell on it since Frick indicated it could resolve itself or at least improve on its own, and he also seemed to downplay the severity of the whole problem. I do hate the thought of surgery, though, and felt like the whole clubfoot process was manageable. Frick is highly regarded apparently by Ponseti. I like him but his whole approach is so laid-back I wonder if he is being too cavalier (sp?) Or am I just a nervous Nellie Thanks, it is so great to be able to read everyone's experiences and gives you some background so you have something else to go on besides what your doctor says. Esp. since I always think of more questions after I leave the office. Zoë mom to Sophie 7-16-05 and 4 yrs Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 22, 2006 Report Share Posted May 22, 2006 Zoe- My son david was born with ABS affected toes-he is missing completely his big toe on his right foot and on his left foot his 4 toes are longer than his big toe. His doctor has never mentioned that his toes would cause him future problems. Our doctor did tell us had I lost my big toe, I would have balance issues but because david was born that way, his body would adapt and his gait would be based on his toes he has. He walks and runs with the best of them. Personally-I would take a wait and see approach before doing anything with Sophie's toes. We did just do an elongation procedure on david's right thumb as it too was abs affected and was amputated at the joint-we did this to help his pincer grasp. I hope this helps! If you have any questions, feel free to email me! kathleen mom to david 20 mo old bcf fab 12/7 > > Hi all, > > My 10 mo. old BCF dtr Sophie had a checkup w/ Dr Frick in Charlotte > this past week. She is on the more severe end of the spectrum esp > her left foot. I dont think she has " atypical/complex " but Im not 100% > sure. (He said he doesnt classify feet that way ?) She has had 2 > tenotomies and is in the p/m's 14/7. Anyway, he said her feet look > good but two things we should keep our eye on: > > Her left foot has lost some dorsiflexion, you can feel how tight the > achilles tendon has become again. You can get it to neutral but not > much beyond. He said we can try to stretch it out a couple of times a > day and the flexibility could improve as she grows and starts walking > (does this sound right?) but otherwise she will need another tenotomy > just on that foot. > > The other issue he pointed out is she has a short big toe relative to > her other toes. I have noticed this before...the ball of her foot is > further down (toward the middle of her foot)than it should be. He > said this is unrelated to clubfoot. Also, it could become less > pronounced as her bones grow. He is going to x-ray her in 3 months > and see how it looks at that point. Apparently you usually see this > short metatarsal in the fourth toe, not the big one. If left > uncorrected it can cause discomfort and pain, and some difficulty > walking etc. There is surgery to lengthen the bone, which he said is > somewhat complicated. I didnt ask if this was something he had > experience with or whether he would recommend us to someone else. I > know Dr. Herzenberg is a specialist in limb lengthening; I dont know > if this qualifies as that. > > My question is, has anyone encountered this short metatarsal problem > along with clubfoot? I am trying not to dwell on it since Frick > indicated it could resolve itself or at least improve on its own, and > he also seemed to downplay the severity of the whole problem. I do > hate the thought of surgery, though, and felt like the whole clubfoot > process was manageable. > > Frick is highly regarded apparently by Ponseti. I like him but his > whole approach is so laid-back I wonder if he is being too cavalier > (sp?) Or am I just a nervous Nellie > > Thanks, it is so great to be able to read everyone's experiences and > gives you some background so you have something else to go on besides > what your doctor says. Esp. since I always think of more questions > after I leave the office. > > Zoë > mom to Sophie 7-16-05 > and 4 yrs > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 22, 2006 Report Share Posted May 22, 2006 Hi Zoe. I too recently had a check-up with Dr. Frick, or I should say my daughter did. She is 2 now. We just recently moved to the Charlotte area. We used to go to Dr. Herzenberg in Baltimore. Dr. Frick was tough to read. Like you said, he is very laid back. I haven't seen first hand any of his work on clubfoot since we only had a check-up. However, Dr H. recommended him to me. I truly value Dr. H's opinion because he is great!!! We are pretty much on auto-pilot from here on out with treatment (hopefully), so it is hard to judge him at this point. I thought he was nice, but very vague. Sorry I am not familiar with the other issue you are having. You could always send Dr. H an email for a second opinion since he is the expert in that area. He always responds to email. I would take several pictures and send them along with your email. Second opinions can never hurt!!! Let me know if you want his email address. HTH!! theresazoe1 wrote: Hi all, My 10 mo. old BCF dtr Sophie had a checkup w/ Dr Frick in Charlotte this past week. She is on the more severe end of the spectrum esp her left foot. I dont think she has " atypical/complex " but Im not 100% sure. (He said he doesnt classify feet that way ?) She has had 2 tenotomies and is in the p/m's 14/7. Anyway, he said her feet look good but two things we should keep our eye on: Her left foot has lost some dorsiflexion, you can feel how tight the achilles tendon has become again. You can get it to neutral but not much beyond. He said we can try to stretch it out a couple of times a day and the flexibility could improve as she grows and starts walking (does this sound right?) but otherwise she will need another tenotomy just on that foot. The other issue he pointed out is she has a short big toe relative to her other toes. I have noticed this before...the ball of her foot is further down (toward the middle of her foot)than it should be. He said this is unrelated to clubfoot. Also, it could become less pronounced as her bones grow. He is going to x-ray her in 3 months and see how it looks at that point. Apparently you usually see this short metatarsal in the fourth toe, not the big one. If left uncorrected it can cause discomfort and pain, and some difficulty walking etc. There is surgery to lengthen the bone, which he said is somewhat complicated. I didnt ask if this was something he had experience with or whether he would recommend us to someone else. I know Dr. Herzenberg is a specialist in limb lengthening; I dont know if this qualifies as that. My question is, has anyone encountered this short metatarsal problem along with clubfoot? I am trying not to dwell on it since Frick indicated it could resolve itself or at least improve on its own, and he also seemed to downplay the severity of the whole problem. I do hate the thought of surgery, though, and felt like the whole clubfoot process was manageable. Frick is highly regarded apparently by Ponseti. I like him but his whole approach is so laid-back I wonder if he is being too cavalier (sp?) Or am I just a nervous Nellie Thanks, it is so great to be able to read everyone's experiences and gives you some background so you have something else to go on besides what your doctor says. Esp. since I always think of more questions after I leave the office. Zoë mom to Sophie 7-16-05 and 4 yrs Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2006 Report Share Posted May 23, 2006 Hi, Zoe, I don't have any direct experience with the issue you describe, but have to say I'd be leery of doing a surgical procedure for something such as a short toe. it seems to me (from a purely unscientific standpoint, I must admit) that it's something that a person could work around .. the way people born without part of a foot, or who lose toes in an accident, do. Maybe it's my bias, but it seems counterintuitive to think that having surgery would prevent more pain than it might cause. You might just trade one sort of pain for another. About dorsiflexion.. my daughter (age 5) doesn't have much dorsiflexion, never has.. but Dr. Ponseti and Dr. Morcuende have told me that a person really doesn't 'need' it to have a well functioning foot. Second tenotomies are indeed sometimes necessary, but it's always better if you could avoid it. Even then, I'd hope he'd try casting first. I know Dr. Frick is well thought of.. but still you've got to follow your gut.. Get a second opinion before you consider anything. Some doctors, even those who use the Ponseti method, seem more willing to suggest surgical options than others. Maybe he'll end up recommending nothing at all. But my advice, would be to lean on the conservative side. You've avoided surgery this far; hopefully you can keep it that way! If it would make you feel better, you could try asking the docs in Iowa, for their opinion. Good luck! > > Hi all, > > My 10 mo. old BCF dtr Sophie had a checkup w/ Dr Frick in Charlotte > this past week. She is on the more severe end of the spectrum esp > her left foot. I dont think she has " atypical/complex " but Im not 100% > sure. (He said he doesnt classify feet that way ?) She has had 2 > tenotomies and is in the p/m's 14/7. Anyway, he said her feet look > good but two things we should keep our eye on: > > Her left foot has lost some dorsiflexion, you can feel how tight the > achilles tendon has become again. You can get it to neutral but not > much beyond. He said we can try to stretch it out a couple of times a > day and the flexibility could improve as she grows and starts walking > (does this sound right?) but otherwise she will need another tenotomy > just on that foot. > > The other issue he pointed out is she has a short big toe relative to > her other toes. I have noticed this before...the ball of her foot is > further down (toward the middle of her foot)than it should be. He > said this is unrelated to clubfoot. Also, it could become less > pronounced as her bones grow. He is going to x-ray her in 3 months > and see how it looks at that point. Apparently you usually see this > short metatarsal in the fourth toe, not the big one. If left > uncorrected it can cause discomfort and pain, and some difficulty > walking etc. There is surgery to lengthen the bone, which he said is > somewhat complicated. I didnt ask if this was something he had > experience with or whether he would recommend us to someone else. I > know Dr. Herzenberg is a specialist in limb lengthening; I dont know > if this qualifies as that. > > My question is, has anyone encountered this short metatarsal problem > along with clubfoot? I am trying not to dwell on it since Frick > indicated it could resolve itself or at least improve on its own, and > he also seemed to downplay the severity of the whole problem. I do > hate the thought of surgery, though, and felt like the whole clubfoot > process was manageable. > > Frick is highly regarded apparently by Ponseti. I like him but his > whole approach is so laid-back I wonder if he is being too cavalier > (sp?) Or am I just a nervous Nellie > > Thanks, it is so great to be able to read everyone's experiences and > gives you some background so you have something else to go on besides > what your doctor says. Esp. since I always think of more questions > after I leave the office. > > Zoë > mom to Sophie 7-16-05 > and 4 yrs > Quote Link to comment Share on other sites More sharing options...
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