Guest guest Posted November 17, 2001 Report Share Posted November 17, 2001 I was wondering what the difference is between the DBB and the FAB? Jody OOPs FAB not DBB Dr. Ponseti would be very dissapointed in me if I did'nt make this correction. Sorry Dr. P., The Cast Lady Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 17, 2001 Report Share Posted November 17, 2001 Jody, Someone else might be able to give further details, but, in an editorial Dr. Ponseti wrote for the Journal of Pediatric Orthopaedics last fall, he said, " To prevent relapse, a foot abduction bar (FAB) (wrongly called Denis- Browne splint) with shoes holding the feet in the same position as in the last cast is worn full time for 3 months and then at night and naps for 3 years. " So, I don't know if it's simply a matter of a difference in names or if there are two types of devices. I know that many of us who use the FAB provided by Iowa slip into calling it the DBB conversationally, just because that seems to be the term most often used by parents. Whenever I talk to Dr. Ponseti we call it " the brace " . > I was wondering what the difference is between the DBB and the FAB? > > Jody > OOPs FAB not DBB > > > Dr. Ponseti would be very dissapointed in me if I did'nt make this > correction. > Sorry Dr. P., > The Cast Lady > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 17, 2001 Report Share Posted November 17, 2001 " So, I don't know if it's simply a matter of a difference in names or if there are two types of devices. " I am not sure either. When I have time I will try and do a search and post a link if I find anything. Quinns brace is a bit different from the ones I have seen pictures of. It is a solid bar, and you cannot lengthen it. The shoes are the same though. Quinn's doc also bends it outwards slightly to keep the feet pronating and in valgus. Jody OOPs FAB not DBB > > > Dr. Ponseti would be very dissapointed in me if I did'nt make this > correction. > Sorry Dr. P., > The Cast Lady > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2001 Report Share Posted November 18, 2001 I looked in Dr. P's book and here's what he says on pg. 80 " The L-shaped plate advocated by Denis Browne (1934) for early correction of the clubfoot is ill-conceived since it attempts to correct the heel varus by everting without abducting the calcaneus, and impossible feat. First described in 1934, the concept of attaching the bandaged feet to plates held by a bar was not new. A device for the correctin of clubfeet consisting of attaching a bar contoured wooden platforms the size of the sole of the foot was proposed by Dr. Henry Neil in 1825, described by L. Attlee in 1868, and reported by L.A. Sayre in 1875 as explained by Le Noir (1966). The object was to have the child 'kick himself straight'. However, any such mechanical device cannot fully correct all the components of the clubfoot deformity. Only after the deformity is fully corrected is a bar attached to shoes in 70 degrees of external rotation effective in maintaining the correction. No money should be wasted on any splint designed to prevent recurrence of the equinus which does not control rotation of the foot. Unless tehy are splinted in firm external rotation the pull of the retracting fibrosis in the ligaments of the medial aspect of the ankle and of the tibialis posterior and toe flexors is strong enough to cause a recurrence of teh deformiyt in most feet. " So, the Denis Browne Splint is a different device all together. The Foot Abduction Bar (FAB) is also called Derotation Splint. They perform different functions. The splints that our kids wear were at some point referred to as DBB's, which is incorrect, technically. If I understand correctly, the DB splint could only control wether the outter edge of the foot was everted (or lifted up). It could not control abduction of the calcaneous (or turning the foot/toes outward..penguin like) and you cannot correct the first problem, without correcting the second. HTH Lori > Dr. Ponseti would be very dissapointed in me if I did'nt make this > correction. > Sorry Dr. P., > The Cast Lady Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2001 Report Share Posted November 18, 2001 Lori, Thanks for the information! I was really wondering what an FAB was. The Dr. that took over my sons last two casts and his tenotomy when Dr. Ponseti had to go to Italy wrote on the order form for the orthotics place " DBB " . Maybe he needs to read Dr. P's book! I looked into getting the book and it was $125.00, did you find it any cheaper? and Caleb 3-31-01 -- In nosurgery4clubfoot@y..., gillam@r... wrote: > I looked in Dr. P's book and here's what he says on pg. 80 > > > " The L-shaped plate advocated by Denis Browne (1934) for early > correction of the clubfoot is ill-conceived since it attempts to > correct the heel varus by everting without abducting the calcaneus, > and impossible feat. First described in 1934, the concept of > attaching the bandaged feet to plates held by a bar was not new. A > device for the correctin of clubfeet consisting of attaching a bar > contoured wooden platforms the size of the sole of the foot was > proposed by Dr. Henry Neil in 1825, described by L. Attlee in > 1868, and reported by L.A. Sayre in 1875 as explained by Le Noir > (1966). The object was to have the child 'kick himself straight'. > However, any such mechanical device cannot fully correct all the > components of the clubfoot deformity. Only after the deformity is > fully corrected is a bar attached to shoes in 70 degrees of external > rotation effective in maintaining the correction. > > No money should be wasted on any splint designed to prevent > recurrence of the equinus which does not control rotation of the > foot. Unless tehy are splinted in firm external rotation the pull of > the retracting fibrosis in the ligaments of the medial aspect of the > ankle and of the tibialis posterior and toe flexors is strong enough > to cause a recurrence of teh deformiyt in most feet. " > > > So, the Denis Browne Splint is a different device all together. The > Foot Abduction Bar (FAB) is also called Derotation Splint. They > perform different functions. The splints that our kids wear were at > some point referred to as DBB's, which is incorrect, technically. If > I understand correctly, the DB splint could only control wether the > outter edge of the foot was everted (or lifted up). It could not > control abduction of the calcaneous (or turning the foot/toes > outward..penguin like) and you cannot correct the first problem, > without correcting the second. > > HTH > > Lori > > > > Dr. Ponseti would be very dissapointed in me if I did'nt make this > > correction. > > Sorry Dr. P., > > The Cast Lady Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2001 Report Share Posted November 18, 2001 Cool. I wonder if there are any pictures in the book or on the net anywhere. Thanks for the information Lori. Jody Re: OOPs FAB not DBB I looked in Dr. P's book and here's what he says on pg. 80 " The L-shaped plate advocated by Denis Browne (1934) for early correction of the clubfoot is ill-conceived since it attempts to correct the heel varus by everting without abducting the calcaneus, and impossible feat. First described in 1934, the concept of attaching the bandaged feet to plates held by a bar was not new. A device for the correctin of clubfeet consisting of attaching a bar contoured wooden platforms the size of the sole of the foot was proposed by Dr. Henry Neil in 1825, described by L. Attlee in 1868, and reported by L.A. Sayre in 1875 as explained by Le Noir (1966). The object was to have the child 'kick himself straight'. However, any such mechanical device cannot fully correct all the components of the clubfoot deformity. Only after the deformity is fully corrected is a bar attached to shoes in 70 degrees of external rotation effective in maintaining the correction. No money should be wasted on any splint designed to prevent recurrence of the equinus which does not control rotation of the foot. Unless tehy are splinted in firm external rotation the pull of the retracting fibrosis in the ligaments of the medial aspect of the ankle and of the tibialis posterior and toe flexors is strong enough to cause a recurrence of teh deformiyt in most feet. " So, the Denis Browne Splint is a different device all together. The Foot Abduction Bar (FAB) is also called Derotation Splint. They perform different functions. The splints that our kids wear were at some point referred to as DBB's, which is incorrect, technically. If I understand correctly, the DB splint could only control wether the outter edge of the foot was everted (or lifted up). It could not control abduction of the calcaneous (or turning the foot/toes outward..penguin like) and you cannot correct the first problem, without correcting the second. HTH Lori > Dr. Ponseti would be very dissapointed in me if I did'nt make this > correction. > Sorry Dr. P., > The Cast Lady Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2001 Report Share Posted November 18, 2001 , When we were going thru treatments we were offered Dr. Ponseti's book for $50.00 but it was awhile ago now, so maybe the price has gone up. Check and see if you can still buy a copy in Iowa. Dr. P showed us a copy of the book right there in the hospital, so they may still do that. Holly and Re: OOPs FAB not DBB >Lori, >Thanks for the information! I was really wondering what an FAB was. >The Dr. that took over my sons last two casts and his tenotomy when >Dr. Ponseti had to go to Italy wrote on the order form for the >orthotics place " DBB " . Maybe he needs to read Dr. P's book! I looked >into getting the book and it was $125.00, did you find it any cheaper? > > and Caleb 3-31-01 > > > >-- In nosurgery4clubfoot@y..., gillam@r... wrote: >> I looked in Dr. P's book and here's what he says on pg. 80 >> >> >> " The L-shaped plate advocated by Denis Browne (1934) for early >> correction of the clubfoot is ill-conceived since it attempts to >> correct the heel varus by everting without abducting the calcaneus, >> and impossible feat. First described in 1934, the concept of >> attaching the bandaged feet to plates held by a bar was not new. A >> device for the correctin of clubfeet consisting of attaching a bar >> contoured wooden platforms the size of the sole of the foot was >> proposed by Dr. Henry Neil in 1825, described by L. Attlee in >> 1868, and reported by L.A. Sayre in 1875 as explained by Le Noir >> (1966). The object was to have the child 'kick himself straight'. >> However, any such mechanical device cannot fully correct all the >> components of the clubfoot deformity. Only after the deformity is >> fully corrected is a bar attached to shoes in 70 degrees of >external >> rotation effective in maintaining the correction. >> >> No money should be wasted on any splint designed to prevent >> recurrence of the equinus which does not control rotation of the >> foot. Unless tehy are splinted in firm external rotation the pull >of >> the retracting fibrosis in the ligaments of the medial aspect of >the >> ankle and of the tibialis posterior and toe flexors is strong >enough >> to cause a recurrence of teh deformiyt in most feet. " >> >> >> So, the Denis Browne Splint is a different device all together. >The >> Foot Abduction Bar (FAB) is also called Derotation Splint. They >> perform different functions. The splints that our kids wear were >at >> some point referred to as DBB's, which is incorrect, technically. >If >> I understand correctly, the DB splint could only control wether the >> outter edge of the foot was everted (or lifted up). It could not >> control abduction of the calcaneous (or turning the foot/toes >> outward..penguin like) and you cannot correct the first problem, >> without correcting the second. >> >> HTH >> >> Lori >> >> >> > Dr. Ponseti would be very dissapointed in me if I did'nt make >this >> > correction. >> > Sorry Dr. P., >> > The Cast Lady > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2001 Report Share Posted November 18, 2001 Lori, Thanks for the quotes. That is essentially what Dr. Ponseti has told me in the past when I asked him. My guess is that the original DBB was L-shaped like a carpenters square. Then the uncorrected children's feet were taped onto the L-shapped metal in an attempt to have them " kick " their feet into a corrected position. The FAB's that most all of us have are not at all like the original DBB from the 1930's; but I am assuming that it have become an accepted term for a brace type of devise made of metal to which children's feet were attached. In the past, I have tried to search for information on Denis Browne but have not found much about him or an actual photo of his original DBB other than that he was from the UK. and > > Dr. Ponseti would be very dissapointed in me if I did'nt make this > > correction. > > Sorry Dr. P., > > The Cast Lady Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2001 Report Share Posted November 18, 2001 Another note: Just yesterday I happened across the following abstract of a journal article that mentioned Denis Browne. I found it in a search of Medline. The abstract doesn't give much info, but thought it might be of interest and, of course, someone could track down the full article for more. Clin Podiatr Med Surg 1997 Jan;14(1):1-7 (ISSN: 0891-8422) Brand PW Department of Orthopedics, University of Washington, Seattle, USA. This article presents the author's experience of having worked in London, England, under Denis Browne, whose method of treating equinovarus in the newborn involved manipulation of the baby feet until full correction had been achieved at the very first visit. The feet were then strapped to the sole plates of the Denis Browne splint, which ensured that the baby's normal kicking action maintained mobility at the subtalar joints and also a basic plantigrade posture. When he transferred to India, the author found a large population of children who had been born with talipes equinovarus, but who had never had treatment. He worked at obtaining correction without strong manipulation, using serial plaster casting followed by Denis Browne's splints. His personal reactions to the problems and the merits of the two methods forms the subject of this article. and > Lori, > > Thanks for the quotes. That is essentially what Dr. Ponseti has told > me in the past when I asked him. My guess is that the original DBB > was L-shaped like a carpenters square. Then the uncorrected > children's feet were taped onto the L-shapped metal in an attempt to > have them " kick " their feet into a corrected position. > > The FAB's that most all of us have are not at all like the original > DBB from the 1930's; but I am assuming that it have become an > accepted term for a brace type of devise made of metal to which > children's feet were attached. > > In the past, I have tried to search for information on Denis Browne > but have not found much about him or an actual photo of his original > DBB other than that he was from the UK. > > and > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2001 Report Share Posted November 18, 2001 I have this article " some where " in my messy office. I purchased it awhile back and as I recall, it was a good read. some of it a bit disturbing though. I will rummage around in my office this evening or tomorrow and see if I can find it, in case anyone is interested. I wish I would have come to read your post a 1/2 hour ago...I've been over at Medline SEARCHING for the description to this article to find if it was really about Browne or about Kite because I couldn't remember for sure. Oh, well...it was quicker than looking for it in my office (did I just admit that?) Lori > > Lori, > > > > Thanks for the quotes. That is essentially what Dr. Ponseti has > told > > me in the past when I asked him. My guess is that the original DBB > > was L-shaped like a carpenters square. Then the uncorrected > > children's feet were taped onto the L-shapped metal in an attempt > to > > have them " kick " their feet into a corrected position. > > > > The FAB's that most all of us have are not at all like the original > > DBB from the 1930's; but I am assuming that it have become an > > accepted term for a brace type of devise made of metal to which > > children's feet were attached. > > > > In the past, I have tried to search for information on Denis Browne > > but have not found much about him or an actual photo of his > original > > DBB other than that he was from the UK. > > > > and > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 19, 2001 Report Share Posted November 19, 2001 After our article on Ponseti's treatment at Shriners came out Dr. Ponseti Wrote me to set me straight on the verbage of the bar used on the shoes. Dr. Ponseti wrote, " ..the use of the term " Denis Browne splint " for the splint which I use which aims at keeping the foot abducted and not everted as was Denis Browne's idea with the plate with a lateral flange to bring the heel in eversion without abducting it - an impossible feat. Foot abduction splint would be a better term. Dr. Ponseti enclosed a few pages of a book by Dr. LeNoir which gave some history of a bar between foot plates which goes back to 1825 (WOW) in this I read... " Actually the essentials of the Denis Browne treatment as we know it today and as outlined by Denis Browne in the 1930's was laid out, according to (Dr.) Sayre. in 1925 by Dr. Neil... " I do not know the year of publication of that book but these show the many years of controversy in treatment of clubfeet. These DBB methods basically left the child up to the correction of their feet once put into th brace. They suposedly as stated by one Dr. " Kick themselves straight " I read a letter in the blue orthopedics journal from a physician in california LA I think, who still uses this method after some casting to complete the correction. Hmmmm... If any one is interested in this piece of Clubfoot history E-mail me your address and I can send you a copy. The Cast Lady- -- In nosurgery4clubfoot@y..., gillam@r... wrote: > I have this article " some where " in my messy office. I purchased it > awhile back and as I recall, it was a good read. some of it a bit > disturbing though. I will rummage around in my office this evening > or tomorrow and see if I can find it, in case anyone is interested. > I wish I would have come to read your post a 1/2 hour ago...I've been > over at Medline SEARCHING for the description to this article to find > if it was really about Browne or about Kite because I couldn't > remember for sure. Oh, well...it was quicker than looking for it in > my office (did I just admit that?) > > Lori > > > > > > > Lori, > > > > > > Thanks for the quotes. That is essentially what Dr. Ponseti has > > told > > > me in the past when I asked him. My guess is that the original > DBB > > > was L-shaped like a carpenters square. Then the uncorrected > > > children's feet were taped onto the L-shapped metal in an attempt > > to > > > have them " kick " their feet into a corrected position. > > > > > > The FAB's that most all of us have are not at all like the > original > > > DBB from the 1930's; but I am assuming that it have become an > > > accepted term for a brace type of devise made of metal to which > > > children's feet were attached. > > > > > > In the past, I have tried to search for information on Denis > Browne > > > but have not found much about him or an actual photo of his > > original > > > DBB other than that he was from the UK. > > > > > > and > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 19, 2001 Report Share Posted November 19, 2001 I posted a link in the Files section to a Word document on Denis Browne. It is a summary I condensed to 3 pages (from 6 pages) written by Dr. Brand on his time spent with Dr. Browne during WWII and Dr. Brands subsequent time in India. It is very interesting reading and Dr. Brand's technique sounds very similar to Dr. Posneti's. Lori Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.