Re: Re: adjustment to Denis Brown brace

[Guest guest]

we had the same problem with DBB shoes wouldn't work right so we went to the

shriners hospital in st. louis to see dr. dobbs. he told us the feet wasn't all

the way corrected he put plaster cast on said that all it should take. He

looked at the DBB said the shoes was to far in and the bar was to short. So we

put in cast two weeks we went back got his braces he said his feet look good got

his braces and no problem been in them for 10 days now we go back on April 24

for a month check up says if everything looks good he will decrease the hours

alittle since my son is over 8 months old.

Larissa and 7-15-05

wrote:

The two biggest culprits in a baby being able to pull his feet out of

the shoes is not being totally corrected and having a bar that is too

short. As far as correction goes, does he have good dorsiflexion

(10-15 degrees)? And was his last cast abducted to about 70 degrees?

It sounds like you guys have really got the shoes on tight this is

good. When you are putting the shoes on are you taking them off the

bar and then applying the shoes and then putting the bar back on?

This is helpful and easy to do if you have a gold bar, the red bar is

not as easy but doable. When you put the foot in the shoe you have to

really push his heel down deep in the heel pocket, it helps if you

bend the knee and push down on the knee and dorsiflex the foot while

you are putting it on. As for bar length, check to see if the heels

of the shoes are shoulder width apart - some people measure bolt to

bolt but some babies are just more comfortable with the heels of the

shoes the same width as the shoulders. There's a picture of how to

measure this in the tips document. Have you seen the tips document

yet? You can find it here:

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

/fab_tips_10_05_05.pdf

Well, I hope some of this helps; just hang in there and we will help

you figure this out because he should not be slipping out of the shoes.

> > >

> > > Our 2 1/2 month old just graduated to the denis brown braces from

> > > casts (after 6 weeks of casting/tenotomy/then another 4 of casting),

> > > and so far is not liking them at all. It's only been 24 hours, but

> > > he's barely ate or slept in that time. I was wondering if others

> > > could share their experiences with these braces. We want to hang on

> > > with his treatment, but I think it would be easier to do if we had a

> > > better of idea of what to expect. At present, I'm very

interested in

> > > how other kids have adjusted to them and how long that took.

> > >

> > > Thanks,

> > > Tom

> > >

> >

>

[Guest guest]

Hi Tom,

OK - a freshly corrected foot DOES have a very rounded heel. That is

because the fat pad (the heel we're used to seeing) is still up very

high. It will drop in a few weeks to a couple o months from now. As

the heel counter in the shoe presses against the tendon to keep the

foot in the shoes, it also pushes that fat toward the bottom of the

heel and it will develop a normal looking pad. Don't worry if the

back part of her heel looks like it's rounded and not quite in the

bottom of the shoe. If you look underneath that rounded part and the

rest of her foot just in front of the rounded part is flat on the

floor/sole of the shoe you're good. Watch it drop over time... you

may not even notice it happening and some day you'll look at her

foot and it'll look just like it should. The heel counters made of

plastizode that used to be necessary for the Markell shoes were

designed to encourage the heels to drop. The newer Markell shoes

have a built in heel counter. That is, the ones without the holes

have this. I've seen these holed shoes once and I'm not entirely

sure there's enough counter in them and you may want to look into

adding the plastizode to these if he heels pull up still. I think,

if you get these holed shoes tight enough you'll see that her heel

starts to push out that hole a bit and the top of the hole will end

up being a natural counter but I'm not sure.

At 06:31 PM 4/6/2006, you wrote:

>Thanks for the help. We've been going over the tips document, and

>that's been helping. He was getting a pressure sore, so we just got

>the Markell shoes with the hole in the back. In so doing, we also

>confirmed what we had wondered about before. Our son's feet are not

>flat -- every since they started casting, the bottom of them has been

>round. Thus, we have the bottom of the feet in the shoes, but the

>heels are not on the soles.

>

>As for correction, I think we were near 70 degrees in the last cast.

>I'm not sure if we were exactly there or not. However, the feet point

>down some when not in the casts -- is that what they should be?

infant feet naturally do this. It is one of the blessings for those

parents of unilateral feet that they can compare a non-affected foot

to the clubfoot and realize that it's just the way they hold their

feet. If you are unsure of correction at all, or simply want to

check you can stand her up and let her bear weight and look at how

she stands. Directly from the back, her foot should be flat on the

floor, it should not roll to the side or look like the inside is not

bearing the same amount of weight as the outside. Directly from the

front, same thing. Foot should be nice and flat. There should be

some abduction when she stands but it's not always apparent. If you

can abduct her foot manually to 70 degrees that is good. To check

dorsiflexion, use your palm and push the foot/toes up as far towards

her head as it'll go. You may have to bend her knee and distract her

to get her to not push against you but once you feel her relax

>The shoulder to shoulder and heel to heel measurements seems similar,

>but shoulder to shoulder is less than bolt to bolt. He's adjusting a

>little better to them, but still not great, and he still screams in

>pain during and a while after we put them on.

Does he actually have a sore? is it pressing on anything now in the

new shoes? Make sure they're very tight. That's really important

and put some weight into pressing him into the shoes with his knee

bent, don't be shy about it. Listen to him and check his feet. If

you see red watch it regularly, if it gets worse you need to find out

why and change something.

The length sounds good. I wouldn't change it just yet. It seems most

babies do best at heel to heel but some babies are much happier at

bolt to bolt so it's probably good to start at heel to heel for now.

let us know how he is tomorrow after the new shoes. Post any time!

Kori

>Thanks again for the help.

>Tom

>

>

> > > > >

> > > > > Our 2 1/2 month old just graduated to the denis brown braces from

> > > > > casts (after 6 weeks of casting/tenotomy/then another 4 of

>casting),

> > > > > and so far is not liking them at all. It's only been 24

>hours, but

> > > > > he's barely ate or slept in that time. I was wondering if others

> > > > > could share their experiences with these braces. We want to

>hang on

> > > > > with his treatment, but I think it would be easier to do if we

>had a

> > > > > better of idea of what to expect. At present, I'm very

> > interested in

> > > > > how other kids have adjusted to them and how long that took.

> > > > >

> > > > > Thanks,

> > > > > Tom

> > > > >

> > > >

> > >

> >

>

>

>

>

>

>

>

[Guest guest]

I got it, welcome Tom!

I';m out of here! (pickup kids school)

Kori

At 02:28 PM 4/7/2006, you wrote:

>,

>

>Just got it 5 minutes ago, and so just now returned now. Of course, I

>just got to go to sleep, so I'll wait till he wakes up to take

>his braces off and take a couple pictures.

>

>Thanks,

>Tom

>

>

> > > > > > > > > >

> > > > > > > > > > Our 2 1/2 month old just graduated to the denis brown

> > > > braces from

> > > > > > > > > > casts (after 6 weeks of casting/tenotomy/then

>another 4 of

> > > > > >casting),

> > > > > > > > > > and so far is not liking them at all. It's only been 24

> > > > > >hours, but

> > > > > > > > > > he's barely ate or slept in that time. I was wondering

> > > > if others

> > > > > > > > > > could share their experiences with these braces. We

>want

> > > > to

> > > > > >hang on

> > > > > > > > > > with his treatment, but I think it would be easier

>to do

> > > > if we

> > > > > >had a

> > > > > > > > > > better of idea of what to expect. At present, I'm very

> > > > > > > interested in

> > > > > > > > > > how other kids have adjusted to them and how long that

> > > > took.

> > > > > > > > > >

> > > > > > > > > > Thanks,

> > > > > > > > > > Tom

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > > >

> > > > > >

> > > > > >

> > > > > >

> > > > > >

> > > > > >