Guest guest Posted May 23, 2006 Report Share Posted May 23, 2006 Hi Ellen and Brage, My daughter Emma had the ATTT performed on both feet 2.5 yrs ago when she had turned 4 yrs old. The procedure is relatively simple and not very invasive. It basically involves detaching the tendon from its natural position and relocating it about 2cm laterally to the third cuneiform. Dr. Ponseti told us that it's a very good operation that leaves no scar on the tendon and continues to improve the foot as the child grows. It is important that the surgeon do a full tendon transfer and not a split tendon transfer. Usually children are released the day of the surgery or kept overnight. I hope this helps and feel free to ask more questions. Dan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2006 Report Share Posted May 23, 2006 Hi Dan. Thanks for the answer. Why is it important that it is a full tendon transfer and not a split tendon transfer? What is the difference between them? We have another problem to.... Dr. Romanus in Sweden recommended the ATTT operation, as the doctor in Norway said that Brage was 'to good' to have the operation. Who shall we trust? Can you describe how 'bad' your daughter feet's was when they decided to do the ATTT. Ellen. RE: : ATTT Hi Ellen and Brage, My daughter Emma had the ATTT performed on both feet 2.5 yrs ago when she had turned 4 yrs old. The procedure is relatively simple and not very invasive. It basically involves detaching the tendon from its natural position and relocating it about 2cm laterally to the third cuneiform. Dr. Ponseti told us that it's a very good operation that leaves no scar on the tendon and continues to improve the foot as the child grows. It is important that the surgeon do a full tendon transfer and not a split tendon transfer. Usually children are released the day of the surgery or kept overnight. I hope this helps and feel free to ask more questions. Dan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2006 Report Share Posted May 23, 2006 Hi Ellen, The split tendon transfer involves spliting the tendon in half and leaving half attached in its natural location while the other half is transfered. This weakens the tendon's pull so that it cannot properly counter the tendency for a relapsed/relapsing foot to pull inward. A full tendon transfer means that the whole tendon is transfered so that it's full strength can be utilized to improve the foot. Emma's right foot did not relapse too badly while the left was considerably stiffer, her arch was high, the heel had turned in and she developed metatarsus adductus. Her right foot had the same problems but to a lesser degree and is now almost perfect. Her left foot is still slowly improving but will always be stiffer than the right. It still tends to turn in but not nearly as badly as the months after the surgery. The metatarsus adductus is still present but mild, the heel has not improved much but doctor Morcuende (in Iowa) told us that this was ok. If you're unsure about how to proceed you can maybe get a third opinion or send a video to Dr. Ponseti of Brage walking . Film him from the back, front and side and also bending his knees to show how much dorsiflexion he has. Dan RE: : ATTT Hi Ellen and Brage, My daughter Emma had the ATTT performed on both feet 2.5 yrs ago when she had turned 4 yrs old. The procedure is relatively simple and not very invasive. It basically involves detaching the tendon from its natural position and relocating it about 2cm laterally to the third cuneiform. Dr. Ponseti told us that it's a very good operation that leaves no scar on the tendon and continues to improve the foot as the child grows. It is important that the surgeon do a full tendon transfer and not a split tendon transfer. Usually children are released the day of the surgery or kept overnight. I hope this helps and feel free to ask more questions. Dan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2006 Report Share Posted May 23, 2006 Hi. First Thank you all for the great response! We have plans to send videos to Dr. Ponseti, and then try to call him for his opinion. Regarding the split tendon transfer versus the full tendon transfer, do you know what's happening to tendon at the outside of the foot, when you do a full tendon transfer? Does it stop working?, or do they start to work together? Ellen RE: : ATTT Hi Ellen and Brage, My daughter Emma had the ATTT performed on both feet 2.5 yrs ago when she had turned 4 yrs old. The procedure is relatively simple and not very invasive. It basically involves detaching the tendon from its natural position and relocating it about 2cm laterally to the third cuneiform. Dr. Ponseti told us that it's a very good operation that leaves no scar on the tendon and continues to improve the foot as the child grows. It is important that the surgeon do a full tendon transfer and not a split tendon transfer. Usually children are released the day of the surgery or kept overnight. I hope this helps and feel free to ask more questions. Dan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2006 Report Share Posted May 23, 2006 Hi Ellen, My son Jake has had ATTT done twice on his left foot. He relapsed when he was a little over two years old. We were told by our dr that we could try re-casting Jake's foot, but that it doesn't work well in older children and he would likely need the ATTT anyways. Jake had his first surgery at the age of 3; this first surgery didn't take for some reason (a very rare thing) and the tendon pulled out a little, so it wasn't working well. Jake needed to have the surgery re-done this past October, when he was 4 1/2 yrs old. He has done great this time!! If he didn't have scars on his foot you'd never know he had surgery. He can run around and jump and climb just like any other little boy. Just my own opinion here...it never hurts to ask about re-casting. Looking back I wish we'd tried casts first before going to surgery, especially since Jake needed the surgery twice. Again I can't stress enough that Jake's was a rare case; most children do great after just one surgery. If you'd like more information, do a search on the message board for ATTT. I've posted many times on this topic both on the nosurgery4clubfoot and the clubfoot boards. Good luck to you and feel free to email me anytime! Kassia 3/22/01 (Lt clubfoot, ATTT x2) 11/22/02 and baby #3 due 12/10/06 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2006 Report Share Posted May 23, 2006 Ellen, The two tendons will work together. It's great that you will contact Dr. Ponseti! Dan RE: : ATTT Hi Ellen and Brage, My daughter Emma had the ATTT performed on both feet 2.5 yrs ago when she had turned 4 yrs old. The procedure is relatively simple and not very invasive. It basically involves detaching the tendon from its natural position and relocating it about 2cm laterally to the third cuneiform. Dr. Ponseti told us that it's a very good operation that leaves no scar on the tendon and continues to improve the foot as the child grows. It is important that the surgeon do a full tendon transfer and not a split tendon transfer. Usually children are released the day of the surgery or kept overnight. I hope this helps and feel free to ask more questions. Dan Quote Link to comment Share on other sites More sharing options...
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