Guest guest Posted May 21, 2002 Report Share Posted May 21, 2002 Ben, I am sorry that Ben appears to be having a problem. I hope that it will be resolved properly. I believe that the word that you are referring to for high arch is " Pes Cavus " . Sometimes doctors refer to it just as cavus. I would think of it as unusual that cavus would still be present at this stage of the treatment as that is the first thing that is corrected in the Ponseti method. At Dr. Ponseti's site he says " To correct the clubfoot, the cavus is corrected first by supinating the forefoot and dorsiflexing the first metatarsal (Figure 3 and Figure 4). The forefoot must never be pronated. " http://www.vh.org/Providers/Textbooks/Clubfoot/Clubfoot.html Also, even though you began with a prior doctor, needing to use 13 Ponseti method casts seems a bit unusual as well. If you wanted to e- mail Dr. Ponseti and/or Dr. Herzenberg about it, I am sure that they would be glad to give you their impressions and/or discuss your child's treatment with your doctor. I would encourage you to contact them. I believe that Dr. Herzenberg had originally trained your doctor in the Ponseti method. Their e-mail addresses and phone numbers in the US are: Dr. Ponseti ignacio-ponseti @ uiowa.edu E. Herzenberg, M.D., FRCSC Sinai Hospital Baltimore, MD Tel: Email: FRCSC @ aol.com I would think that you could also ask Dr. De Kiewiet directly if there is still an unresolved problem and what he feels needs to be done if anything. I hope that this information is of help. Please keep us informed in how things are going. and (3-17-99) > Sorry to be specific with this . > > It`s obvious you have a very sound understanding of the > technique and I am sure you will have read about or discussed > most of the problems encountered with clubfoot. > > Ben now appears in my opinion to have a stiff foot. Mr de Kiewiet > does not appear to be too concerned at the moment. > > As a parent you pick up on every change and your mind works > overtime. > > Ben's foot is now in the corrected position, however his foot is > short and puffy with a very pronounced arch. It would appear that > he has some other problem with the forefoot. > > We have heard of a term " Paws Crevice " (dangerous thing - little > information) and I am curious if you have ever heard of this? > > Or similarly do you recall any specific papers/ studies or parents > discussing a similar foot shape? > > Thanks in advance. > > Tom, Corinne & Ben (unilateral 11,19,01) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 2002 Report Share Posted May 21, 2002 Ben, I am sorry that Ben appears to be having a problem. I hope that it will be resolved properly. I believe that the word that you are referring to for high arch is " Pes Cavus " . Sometimes doctors refer to it just as cavus. I would think of it as unusual that cavus would still be present at this stage of the treatment as that is the first thing that is corrected in the Ponseti method. At Dr. Ponseti's site he says " To correct the clubfoot, the cavus is corrected first by supinating the forefoot and dorsiflexing the first metatarsal (Figure 3 and Figure 4). The forefoot must never be pronated. " http://www.vh.org/Providers/Textbooks/Clubfoot/Clubfoot.html Also, even though you began with a prior doctor, needing to use 13 Ponseti method casts seems a bit unusual as well. If you wanted to e- mail Dr. Ponseti and/or Dr. Herzenberg about it, I am sure that they would be glad to give you their impressions and/or discuss your child's treatment with your doctor. I would encourage you to contact them. I believe that Dr. Herzenberg had originally trained your doctor in the Ponseti method. Their e-mail addresses and phone numbers in the US are: Dr. Ponseti ignacio-ponseti @ uiowa.edu E. Herzenberg, M.D., FRCSC Sinai Hospital Baltimore, MD Tel: Email: FRCSC @ aol.com I would think that you could also ask Dr. De Kiewiet directly if there is still an unresolved problem and what he feels needs to be done if anything. I hope that this information is of help. Please keep us informed in how things are going. and (3-17-99) > Sorry to be specific with this . > > It`s obvious you have a very sound understanding of the > technique and I am sure you will have read about or discussed > most of the problems encountered with clubfoot. > > Ben now appears in my opinion to have a stiff foot. Mr de Kiewiet > does not appear to be too concerned at the moment. > > As a parent you pick up on every change and your mind works > overtime. > > Ben's foot is now in the corrected position, however his foot is > short and puffy with a very pronounced arch. It would appear that > he has some other problem with the forefoot. > > We have heard of a term " Paws Crevice " (dangerous thing - little > information) and I am curious if you have ever heard of this? > > Or similarly do you recall any specific papers/ studies or parents > discussing a similar foot shape? > > Thanks in advance. > > Tom, Corinne & Ben (unilateral 11,19,01) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 2002 Report Share Posted May 21, 2002 , I hope you don't mind my " BUTTING " in here but I have seen and felt these feet. If I am hearing you right your son probably has a deep transverse crease on the sole of his foot. This is a crease that I have seen develop as the correction is progressing and the foot seems to change and become stiffer then in the begining phases of correction. These feet have a more pronounced mid foot deformity than most " normal Clubfeet " and need some extra casting to try and correct this stiff Cavus abnormality. These may be feet that have some other needs in the way of surgery. I have also wondered if some of these feet that are " Bad actors " (if you will) have any other neurologic issues. We have found some spinal cord issues in older kids who have had really stiff reccurant feet. I do belive the casting we have continued on these feet under Dr. Ponseti's recommendations have helped to prevent some extensive surgical correction. There are a small number of feet that do need some more intense surgical correction even with the Ponseti method just because they are not " normal Clubfeet " . Good luck~~~The cast lady -- In nosurgery4clubfoot@y..., " martin_egbert " <martinegbert@e...> wrote: > Ben, > > I am sorry that Ben appears to be having a problem. I hope that it > will be resolved properly. > > I believe that the word that you are referring to for high arch > is " Pes Cavus " . Sometimes doctors refer to it just as cavus. > > I would think of it as unusual that cavus would still be present at > this stage of the treatment as that is the first thing that is > corrected in the Ponseti method. At Dr. Ponseti's site he says " To > correct the clubfoot, the cavus is corrected first by supinating the > forefoot and dorsiflexing the first metatarsal (Figure 3 and Figure > 4). The forefoot must never be pronated. " > http://www.vh.org/Providers/Textbooks/Clubfoot/Clubfoot.html > > Also, even though you began with a prior doctor, needing to use 13 > Ponseti method casts seems a bit unusual as well. If you wanted to e- > mail Dr. Ponseti and/or Dr. Herzenberg about it, I am sure that they > would be glad to give you their impressions and/or discuss your > child's treatment with your doctor. I would encourage you to contact > them. I believe that Dr. Herzenberg had originally trained your > doctor in the Ponseti method. > > Their e-mail addresses and phone numbers in the US are: > > Dr. Ponseti ignacio-ponseti @ uiowa.edu > > E. Herzenberg, M.D., FRCSC > Sinai Hospital > Baltimore, MD > Tel: > Email: FRCSC @ aol.com > > I would think that you could also ask Dr. De Kiewiet directly if > there is still an unresolved problem and what he feels needs to be > done if anything. > > I hope that this information is of help. Please keep us informed in > how things are going. > > and (3-17-99) > > > > > > > > > > > Sorry to be specific with this . > > > > It`s obvious you have a very sound understanding of the > > technique and I am sure you will have read about or discussed > > most of the problems encountered with clubfoot. > > > > Ben now appears in my opinion to have a stiff foot. Mr de Kiewiet > > does not appear to be too concerned at the moment. > > > > As a parent you pick up on every change and your mind works > > overtime. > > > > Ben's foot is now in the corrected position, however his foot is > > short and puffy with a very pronounced arch. It would appear that > > he has some other problem with the forefoot. > > > > We have heard of a term " Paws Crevice " (dangerous thing - little > > information) and I am curious if you have ever heard of this? > > > > Or similarly do you recall any specific papers/ studies or parents > > discussing a similar foot shape? > > > > Thanks in advance. > > > > Tom, Corinne & Ben (unilateral 11,19,01) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 2002 Report Share Posted May 21, 2002 , I hope you don't mind my " BUTTING " in here but I have seen and felt these feet. If I am hearing you right your son probably has a deep transverse crease on the sole of his foot. This is a crease that I have seen develop as the correction is progressing and the foot seems to change and become stiffer then in the begining phases of correction. These feet have a more pronounced mid foot deformity than most " normal Clubfeet " and need some extra casting to try and correct this stiff Cavus abnormality. These may be feet that have some other needs in the way of surgery. I have also wondered if some of these feet that are " Bad actors " (if you will) have any other neurologic issues. We have found some spinal cord issues in older kids who have had really stiff reccurant feet. I do belive the casting we have continued on these feet under Dr. Ponseti's recommendations have helped to prevent some extensive surgical correction. There are a small number of feet that do need some more intense surgical correction even with the Ponseti method just because they are not " normal Clubfeet " . Good luck~~~The cast lady -- In nosurgery4clubfoot@y..., " martin_egbert " <martinegbert@e...> wrote: > Ben, > > I am sorry that Ben appears to be having a problem. I hope that it > will be resolved properly. > > I believe that the word that you are referring to for high arch > is " Pes Cavus " . Sometimes doctors refer to it just as cavus. > > I would think of it as unusual that cavus would still be present at > this stage of the treatment as that is the first thing that is > corrected in the Ponseti method. At Dr. Ponseti's site he says " To > correct the clubfoot, the cavus is corrected first by supinating the > forefoot and dorsiflexing the first metatarsal (Figure 3 and Figure > 4). The forefoot must never be pronated. " > http://www.vh.org/Providers/Textbooks/Clubfoot/Clubfoot.html > > Also, even though you began with a prior doctor, needing to use 13 > Ponseti method casts seems a bit unusual as well. If you wanted to e- > mail Dr. Ponseti and/or Dr. Herzenberg about it, I am sure that they > would be glad to give you their impressions and/or discuss your > child's treatment with your doctor. I would encourage you to contact > them. I believe that Dr. Herzenberg had originally trained your > doctor in the Ponseti method. > > Their e-mail addresses and phone numbers in the US are: > > Dr. Ponseti ignacio-ponseti @ uiowa.edu > > E. Herzenberg, M.D., FRCSC > Sinai Hospital > Baltimore, MD > Tel: > Email: FRCSC @ aol.com > > I would think that you could also ask Dr. De Kiewiet directly if > there is still an unresolved problem and what he feels needs to be > done if anything. > > I hope that this information is of help. Please keep us informed in > how things are going. > > and (3-17-99) > > > > > > > > > > > Sorry to be specific with this . > > > > It`s obvious you have a very sound understanding of the > > technique and I am sure you will have read about or discussed > > most of the problems encountered with clubfoot. > > > > Ben now appears in my opinion to have a stiff foot. Mr de Kiewiet > > does not appear to be too concerned at the moment. > > > > As a parent you pick up on every change and your mind works > > overtime. > > > > Ben's foot is now in the corrected position, however his foot is > > short and puffy with a very pronounced arch. It would appear that > > he has some other problem with the forefoot. > > > > We have heard of a term " Paws Crevice " (dangerous thing - little > > information) and I am curious if you have ever heard of this? > > > > Or similarly do you recall any specific papers/ studies or parents > > discussing a similar foot shape? > > > > Thanks in advance. > > > > Tom, Corinne & Ben (unilateral 11,19,01) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 2002 Report Share Posted May 21, 2002 , Thanks, looking as some detail on the internet " Pes Cavus " is the term that I had been looking for. Speaking with Mr De Kiewiet he is not totally concerened with the forefoot difficulties and feels that they might well spontaneously corect themselves and if not then we can deal with them at a later stage. At the moment there is a lot of soft tissue sweeling and it appears difficult to diagnose the exact problem. His main focus is on the correction of the clubfoot position. I will take your advice and send some pictures and detail to Dr Ponseti. Thank you for the encouragement. Tom, Corinne & Ben. > > Sorry to be specific with this . > > > > It`s obvious you have a very sound understanding of the > > technique and I am sure you will have read about or discussed > > most of the problems encountered with clubfoot. > > > > Ben now appears in my opinion to have a stiff foot. Mr de Kiewiet > > does not appear to be too concerned at the moment. > > > > As a parent you pick up on every change and your mind works > > overtime. > > > > Ben's foot is now in the corrected position, however his foot is > > short and puffy with a very pronounced arch. It would appear that > > he has some other problem with the forefoot. > > > > We have heard of a term " Paws Crevice " (dangerous thing - little > > information) and I am curious if you have ever heard of this? > > > > Or similarly do you recall any specific papers/ studies or parents > > discussing a similar foot shape? > > > > Thanks in advance. > > > > Tom, Corinne & Ben (unilateral 11,19,01) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 2002 Report Share Posted May 21, 2002 , Thanks, looking as some detail on the internet " Pes Cavus " is the term that I had been looking for. Speaking with Mr De Kiewiet he is not totally concerened with the forefoot difficulties and feels that they might well spontaneously corect themselves and if not then we can deal with them at a later stage. At the moment there is a lot of soft tissue sweeling and it appears difficult to diagnose the exact problem. His main focus is on the correction of the clubfoot position. I will take your advice and send some pictures and detail to Dr Ponseti. Thank you for the encouragement. Tom, Corinne & Ben. > > Sorry to be specific with this . > > > > It`s obvious you have a very sound understanding of the > > technique and I am sure you will have read about or discussed > > most of the problems encountered with clubfoot. > > > > Ben now appears in my opinion to have a stiff foot. Mr de Kiewiet > > does not appear to be too concerned at the moment. > > > > As a parent you pick up on every change and your mind works > > overtime. > > > > Ben's foot is now in the corrected position, however his foot is > > short and puffy with a very pronounced arch. It would appear that > > he has some other problem with the forefoot. > > > > We have heard of a term " Paws Crevice " (dangerous thing - little > > information) and I am curious if you have ever heard of this? > > > > Or similarly do you recall any specific papers/ studies or parents > > discussing a similar foot shape? > > > > Thanks in advance. > > > > Tom, Corinne & Ben (unilateral 11,19,01) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 2002 Report Share Posted May 21, 2002 Please feel free to " but " in. I hoped those with any info would. Ben's foot is very similar to those you describe, in that, as the castings have progressed the foot has changed and almost tightened up with the resulting crease in the sole. It's good to hear that more castings are useful in preventing some intensive surgical correction. The way things are going with his foot I'm sure there is a long road ahead which is bound to involve some other more invasive treatment. We can only hope that the work being done now will go along way towards preventing unnecessary work. We keep praying and I am going to e-mail Dr Ponseti directly as had recommended. Thanks for the info. Tom, Corinne & Ben. > > > Sorry to be specific with this . > > > > > > It`s obvious you have a very sound understanding of the > > > technique and I am sure you will have read about or discussed > > > most of the problems encountered with clubfoot. > > > > > > Ben now appears in my opinion to have a stiff foot. Mr de Kiewiet > > > does not appear to be too concerned at the moment. > > > > > > As a parent you pick up on every change and your mind works > > > overtime. > > > > > > Ben's foot is now in the corrected position, however his foot is > > > short and puffy with a very pronounced arch. It would appear that > > > he has some other problem with the forefoot. > > > > > > We have heard of a term " Paws Crevice " (dangerous thing - little > > > information) and I am curious if you have ever heard of this? > > > > > > Or similarly do you recall any specific papers/ studies or parents > > > discussing a similar foot shape? > > > > > > Thanks in advance. > > > > > > Tom, Corinne & Ben (unilateral 11,19,01) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 2002 Report Share Posted May 21, 2002 Beth, I have read some about the spinal cord problems in some rare cases. What types of problems have you seen? I am just curious. Thanks and Caleb 3-31-01 Re: Question to , I hope you don't mind my " BUTTING " in here but I have seen and felt these feet. If I am hearing you right your son probably has a deep transverse crease on the sole of his foot. This is a crease that I have seen develop as the correction is progressing and the foot seems to change and become stiffer then in the begining phases of correction. These feet have a more pronounced mid foot deformity than most " normal Clubfeet " and need some extra casting to try and correct this stiff Cavus abnormality. These may be feet that have some other needs in the way of surgery. I have also wondered if some of these feet that are " Bad actors " (if you will) have any other neurologic issues. We have found some spinal cord issues in older kids who have had really stiff reccurant feet. I do belive the casting we have continued on these feet under Dr. Ponseti's recommendations have helped to prevent some extensive surgical correction. There are a small number of feet that do need some more intense surgical correction even with the Ponseti method just because they are not " normal Clubfeet " . Good luck~~~The cast lady -- In nosurgery4clubfoot@y..., " martin_egbert " <martinegbert@e...> wrote: > Ben, > > I am sorry that Ben appears to be having a problem. I hope that it > will be resolved properly. > > I believe that the word that you are referring to for high arch > is " Pes Cavus " . Sometimes doctors refer to it just as cavus. > > I would think of it as unusual that cavus would still be present at > this stage of the treatment as that is the first thing that is > corrected in the Ponseti method. At Dr. Ponseti's site he says " To > correct the clubfoot, the cavus is corrected first by supinating the > forefoot and dorsiflexing the first metatarsal (Figure 3 and Figure > 4). The forefoot must never be pronated. " > http://www.vh.org/Providers/Textbooks/Clubfoot/Clubfoot.html > > Also, even though you began with a prior doctor, needing to use 13 > Ponseti method casts seems a bit unusual as well. If you wanted to e- > mail Dr. Ponseti and/or Dr. Herzenberg about it, I am sure that they > would be glad to give you their impressions and/or discuss your > child's treatment with your doctor. I would encourage you to contact > them. I believe that Dr. Herzenberg had originally trained your > doctor in the Ponseti method. > > Their e-mail addresses and phone numbers in the US are: > > Dr. Ponseti ignacio-ponseti @ uiowa.edu > > E. Herzenberg, M.D., FRCSC > Sinai Hospital > Baltimore, MD > Tel: > Email: FRCSC @ aol.com > > I would think that you could also ask Dr. De Kiewiet directly if > there is still an unresolved problem and what he feels needs to be > done if anything. > > I hope that this information is of help. Please keep us informed in > how things are going. > > and (3-17-99) > > > > > > > > > > > Sorry to be specific with this . > > > > It`s obvious you have a very sound understanding of the > > technique and I am sure you will have read about or discussed > > most of the problems encountered with clubfoot. > > > > Ben now appears in my opinion to have a stiff foot. Mr de Kiewiet > > does not appear to be too concerned at the moment. > > > > As a parent you pick up on every change and your mind works > > overtime. > > > > Ben's foot is now in the corrected position, however his foot is > > short and puffy with a very pronounced arch. It would appear that > > he has some other problem with the forefoot. > > > > We have heard of a term " Paws Crevice " (dangerous thing - little > > information) and I am curious if you have ever heard of this? > > > > Or similarly do you recall any specific papers/ studies or parents > > discussing a similar foot shape? > > > > Thanks in advance. > > > > Tom, Corinne & Ben (unilateral 11,19,01) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 2002 Report Share Posted May 21, 2002 Beth, I have read some about the spinal cord problems in some rare cases. What types of problems have you seen? I am just curious. Thanks and Caleb 3-31-01 Re: Question to , I hope you don't mind my " BUTTING " in here but I have seen and felt these feet. If I am hearing you right your son probably has a deep transverse crease on the sole of his foot. This is a crease that I have seen develop as the correction is progressing and the foot seems to change and become stiffer then in the begining phases of correction. These feet have a more pronounced mid foot deformity than most " normal Clubfeet " and need some extra casting to try and correct this stiff Cavus abnormality. These may be feet that have some other needs in the way of surgery. I have also wondered if some of these feet that are " Bad actors " (if you will) have any other neurologic issues. We have found some spinal cord issues in older kids who have had really stiff reccurant feet. I do belive the casting we have continued on these feet under Dr. Ponseti's recommendations have helped to prevent some extensive surgical correction. There are a small number of feet that do need some more intense surgical correction even with the Ponseti method just because they are not " normal Clubfeet " . Good luck~~~The cast lady -- In nosurgery4clubfoot@y..., " martin_egbert " <martinegbert@e...> wrote: > Ben, > > I am sorry that Ben appears to be having a problem. I hope that it > will be resolved properly. > > I believe that the word that you are referring to for high arch > is " Pes Cavus " . Sometimes doctors refer to it just as cavus. > > I would think of it as unusual that cavus would still be present at > this stage of the treatment as that is the first thing that is > corrected in the Ponseti method. At Dr. Ponseti's site he says " To > correct the clubfoot, the cavus is corrected first by supinating the > forefoot and dorsiflexing the first metatarsal (Figure 3 and Figure > 4). The forefoot must never be pronated. " > http://www.vh.org/Providers/Textbooks/Clubfoot/Clubfoot.html > > Also, even though you began with a prior doctor, needing to use 13 > Ponseti method casts seems a bit unusual as well. If you wanted to e- > mail Dr. Ponseti and/or Dr. Herzenberg about it, I am sure that they > would be glad to give you their impressions and/or discuss your > child's treatment with your doctor. I would encourage you to contact > them. I believe that Dr. Herzenberg had originally trained your > doctor in the Ponseti method. > > Their e-mail addresses and phone numbers in the US are: > > Dr. Ponseti ignacio-ponseti @ uiowa.edu > > E. Herzenberg, M.D., FRCSC > Sinai Hospital > Baltimore, MD > Tel: > Email: FRCSC @ aol.com > > I would think that you could also ask Dr. De Kiewiet directly if > there is still an unresolved problem and what he feels needs to be > done if anything. > > I hope that this information is of help. Please keep us informed in > how things are going. > > and (3-17-99) > > > > > > > > > > > Sorry to be specific with this . > > > > It`s obvious you have a very sound understanding of the > > technique and I am sure you will have read about or discussed > > most of the problems encountered with clubfoot. > > > > Ben now appears in my opinion to have a stiff foot. Mr de Kiewiet > > does not appear to be too concerned at the moment. > > > > As a parent you pick up on every change and your mind works > > overtime. > > > > Ben's foot is now in the corrected position, however his foot is > > short and puffy with a very pronounced arch. It would appear that > > he has some other problem with the forefoot. > > > > We have heard of a term " Paws Crevice " (dangerous thing - little > > information) and I am curious if you have ever heard of this? > > > > Or similarly do you recall any specific papers/ studies or parents > > discussing a similar foot shape? > > > > Thanks in advance. > > > > Tom, Corinne & Ben (unilateral 11,19,01) Quote Link to comment Share on other sites More sharing options...
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