Older child just starting out with Ponseti + has deformed foot

[Guest guest]

Hi, I am posting on behalf of a mum to an 18month old who has

unilateral C.F. and 3 metatarsals going to a double big toe and two

smaller toes. You may know me as mum to with bilateral c.f.

now 2.5 years & doing well but with suspected Perthes (not related to

c.f.).

Ok, unfortunately my new friend went to the local doctor and he

strapped the child's foot. As a baby, the child underwent a standard

tenotomy. Foot is still curved and not fully corrected so Mum has

just taken the child, who is now 18 months old, to our Consultant.

Our Consultant's physio has put a soft cast under the knee cast on and

though the child is pretty happy to walk about, frankly his mother nor

I are convinced this cast is actually doing anything! It is due to

stay on for 2 weeks.

OK - I would VERY much appreciate advice:-

1) What is the oldest a child can be to start the Ponseti method / is

18 months old too late?

2) Is anyone else in the same position ie, 3 toes & treatment for

talipes? My friend could really do with some support as this is not a

straightforward case

3) Can you confirm - that as the child is 18months - casts should be

plaster of paris to thigh level as per standard technique.

Thanks

[Guest guest]

I am aware that our doctor, Dr. Pirani, has treated children much older than

this with success as he travels to Uganda several times a year. Just the other

day he mentioned a three year old he had success with. I am not sure what

course of treatment he took, but I know that he would have tried all components

of the Ponseti Method first before he went further than that.

amandajlear wrote: Hi, I

am posting on behalf of a mum to an 18month old who has

unilateral C.F. and 3 metatarsals going to a double big toe and two

smaller toes. You may know me as mum to with bilateral c.f.

now 2.5 years & doing well but with suspected Perthes (not related to

c.f.).

Ok, unfortunately my new friend went to the local doctor and he

strapped the child's foot. As a baby, the child underwent a standard

tenotomy. Foot is still curved and not fully corrected so Mum has

just taken the child, who is now 18 months old, to our Consultant.

Our Consultant's physio has put a soft cast under the knee cast on and

though the child is pretty happy to walk about, frankly his mother nor

I are convinced this cast is actually doing anything! It is due to

stay on for 2 weeks.

OK - I would VERY much appreciate advice:-

1) What is the oldest a child can be to start the Ponseti method / is

18 months old too late?

2) Is anyone else in the same position ie, 3 toes & treatment for

talipes? My friend could really do with some support as this is not a

straightforward case

3) Can you confirm - that as the child is 18months - casts should be

plaster of paris to thigh level as per standard technique.

Thanks

__________________________________________________

[Guest guest]

,

It used to be that 18 months was considered the " outside edge " of

being able to use the Ponseti method. Today, the most proficient

Ponseti docs are treating children at much older ages, 4 and 5 year

olds even. So it is still very likely that he would be able to be

corrected by the Ponseti method!

I would have to know what his bone structure is like to give you a

definitive answer on whether or not his toe situation would affect the

correction. Chances are if the deformity only exists in the

metatarsals (toe bones) that the rest of the foot should correct just

fine and give him a comfortable flexible foot. If you can find out

more about this (have they done x-rays?), I would be happy to look

into it for you and give you and your friend more feedback on this aspect.

I can't really think of a reason for the short leg cast, but I would

not rule out the possibility that it could be okay. If the residual

clubfoot deformity is only in the forefoot, and the rest of the foot

is properly aligned, there is a chance that a short leg cast might

work. This is purely speculative though, I'm just guessing based on

what you said, and truly, to answer your question, I don't believe

that it is ever called for in the Ponseti protocol to use a short leg

cast.

Is your consultant on Dr. Ponseti's qualified physicians list? And

did he/she successfully correct 's feet? My personal

recommendation would be to question the doctor as to why he/she is

using a short leg cast and get a second opinion if your friend is not

seeing the desired results after this cast comes off.

Hope this helps,

>

> Hi, I am posting on behalf of a mum to an 18month old who has

> unilateral C.F. and 3 metatarsals going to a double big toe and two

> smaller toes. You may know me as mum to with bilateral c.f.

> now 2.5 years & doing well but with suspected Perthes (not related to

> c.f.).

>

> Ok, unfortunately my new friend went to the local doctor and he

> strapped the child's foot. As a baby, the child underwent a standard

> tenotomy. Foot is still curved and not fully corrected so Mum has

> just taken the child, who is now 18 months old, to our Consultant.

>

> Our Consultant's physio has put a soft cast under the knee cast on and

> though the child is pretty happy to walk about, frankly his mother nor

> I are convinced this cast is actually doing anything! It is due to

> stay on for 2 weeks.

>

> OK - I would VERY much appreciate advice:-

> 1) What is the oldest a child can be to start the Ponseti method / is

> 18 months old too late?

> 2) Is anyone else in the same position ie, 3 toes & treatment for

> talipes? My friend could really do with some support as this is not a

> straightforward case

> 3) Can you confirm - that as the child is 18months - casts should be

> plaster of paris to thigh level as per standard technique.

>

> Thanks

>

>

[Guest guest]

Hey !

We talked with our Dr. about how old a child can be. He is currently

treating a 9 year old from Africa. The 9 year old did need to have the ATT

done. I would not think that an 18 month old would need to. At 18 months old

you bones are still very flexible.

The cast is not doing anything IMO (in my opinion). The casts need to be a

full length and the foot needs to be at a 90 angle.

This is the one thing that Dillon's first DR. screwed up on. IF the bones are

not aligned and at a 90 angle then it is not Ponseti and will not work. This

leads to the Dr.'s high rates of surgery.

Children starting at 18 months I believe have to wear the bar longer than kids

beginning with it. Dillon will be 4 before he won't have to wear the bar any

longer.

Hope this answers your questions.

LaRena

amandajlear wrote:

Hi, I am posting on behalf of a mum to an 18month old who has

unilateral C.F. and 3 metatarsals going to a double big toe and two

smaller toes. You may know me as mum to with bilateral c.f.

now 2.5 years & doing well but with suspected Perthes (not related to

c.f.).

Ok, unfortunately my new friend went to the local doctor and he

strapped the child's foot. As a baby, the child underwent a standard

tenotomy. Foot is still curved and not fully corrected so Mum has

just taken the child, who is now 18 months old, to our Consultant.

Our Consultant's physio has put a soft cast under the knee cast on and

though the child is pretty happy to walk about, frankly his mother nor

I are convinced this cast is actually doing anything! It is due to

stay on for 2 weeks.

OK - I would VERY much appreciate advice:-

1) What is the oldest a child can be to start the Ponseti method / is

18 months old too late?

2) Is anyone else in the same position ie, 3 toes & treatment for

talipes? My friend could really do with some support as this is not a

straightforward case

3) Can you confirm - that as the child is 18months - casts should be

plaster of paris to thigh level as per standard technique.

Thanks

[Guest guest]

-

My son was born with bilateral clubfeet as well as " toe issues " . His

digits both on his hand and feet were affected by abs at birth. He

has only 4 toes on his right foot and those 4 toes are shortened. He

was treated at birth with the ponseti method. For the most part, no

changes to ponseti protocol has been necessary even though he has

toe issues. I would suggest getting your friends son to a ponseti

certified doctor if possible!! That makes all the difference in the

world.

Best wishes!

kathleen

mom to david bcf fab 12/7 21 mo old

and daughter edd 9/1/06

>

> Hi, I am posting on behalf of a mum to an 18month old who has

> unilateral C.F. and 3 metatarsals going to a double big toe and two

> smaller toes. You may know me as mum to with bilateral

c.f.

> now 2.5 years & doing well but with suspected Perthes (not related

to

> c.f.).

>

> Ok, unfortunately my new friend went to the local doctor and he

> strapped the child's foot. As a baby, the child underwent a

standard

> tenotomy. Foot is still curved and not fully corrected so Mum has

> just taken the child, who is now 18 months old, to our

Consultant.

>

> Our Consultant's physio has put a soft cast under the knee cast on

and

> though the child is pretty happy to walk about, frankly his mother

nor

> I are convinced this cast is actually doing anything! It is due to

> stay on for 2 weeks.

>

> OK - I would VERY much appreciate advice:-

> 1) What is the oldest a child can be to start the Ponseti method /

is

> 18 months old too late?

> 2) Is anyone else in the same position ie, 3 toes & treatment for

> talipes? My friend could really do with some support as this is

not a

> straightforward case

> 3) Can you confirm - that as the child is 18months - casts should

be

> plaster of paris to thigh level as per standard technique.

>

> Thanks

>

>