Guest guest Posted January 3, 2003 Report Share Posted January 3, 2003 Hi, Amy! Glad you decided to de-lurk! Your is almost the same age as my daughter, she was born on the 16th of March. I don't know how many parents here have had their child go through the ATTT surgery. might have a better idea of that. I believe that Anandhi's child (who participates on the Parentsplace clubfoot board) had the ATTT, but I don't think she posts here. Has been back to see the doctors in Iowa since he was 18 months old? Perhaps you could arrange another follow up with them since he's older now to see how they think his feet are progressing and get their opinion on trying the surgery. In my opinion, Dr. P is the expert, and I'd trust his opinion first and foremost. I'm not sure if there is an age limit on performing the ATTT, or if there is an advantage of doing it now versus doing it after age 4. I guess if I were in your situation, those would be the questions that I'd want answered. I do know that the tendon transfer surgery is supposed to be a lot less invasive than the PMR surgery. How many of the tendon transfers has your doctor performed? Has he been able to show you before/after photos? I know that they're pretty familiar with the surgery in Iowa and perhaps they could tell you more about it and their experiences. I hope you'll keep us posted on your decisions and let us help support you. Hugs to you- I know how trying these things are- I'm also in the midst of making some treatment decisions about my daughter's foot and will be heading to Iowa in a few weeks. Regards, & (3-16-00) left clubfoot > I have been reading postings for about a year. was treated by Dr. Latz at Children's Mercy in Kansas City, MO. He had a series of 6 castings and tenonomy at 8 weeks. We wore DBB for 3 months 20 hours a day and then went to nights only. He did not tolerate the bar well at all. is the only one of Dr. Latz's patients with his particular malformation. His feet were severe, but could be turned neutral very easily. His foot, however, continues to be in the shape of a " C " due to the strength of the muscule on the inside of his foot. After seeing Dr. Ponseti at 18 months, (he said he had only seen about 3 or 4 cases like 's before) he would walk out of it by age 3 or 4. Dr. Latz wants to do surgery to move the tibial tendon from the medial location on the foot to the middle of the foot. He thinks this will reshape his foot enough to allow him to wear regular shoes his whole life. He wears regular shoes at this time and does not complain. I guess my question is whether anyone else has had this surgery? Please inform me if you have, we are having a hard time deciding what to do. > > Amy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 3, 2003 Report Share Posted January 3, 2003 Hi, Amy! Glad you decided to de-lurk! Your is almost the same age as my daughter, she was born on the 16th of March. I don't know how many parents here have had their child go through the ATTT surgery. might have a better idea of that. I believe that Anandhi's child (who participates on the Parentsplace clubfoot board) had the ATTT, but I don't think she posts here. Has been back to see the doctors in Iowa since he was 18 months old? Perhaps you could arrange another follow up with them since he's older now to see how they think his feet are progressing and get their opinion on trying the surgery. In my opinion, Dr. P is the expert, and I'd trust his opinion first and foremost. I'm not sure if there is an age limit on performing the ATTT, or if there is an advantage of doing it now versus doing it after age 4. I guess if I were in your situation, those would be the questions that I'd want answered. I do know that the tendon transfer surgery is supposed to be a lot less invasive than the PMR surgery. How many of the tendon transfers has your doctor performed? Has he been able to show you before/after photos? I know that they're pretty familiar with the surgery in Iowa and perhaps they could tell you more about it and their experiences. I hope you'll keep us posted on your decisions and let us help support you. Hugs to you- I know how trying these things are- I'm also in the midst of making some treatment decisions about my daughter's foot and will be heading to Iowa in a few weeks. Regards, & (3-16-00) left clubfoot > I have been reading postings for about a year. was treated by Dr. Latz at Children's Mercy in Kansas City, MO. He had a series of 6 castings and tenonomy at 8 weeks. We wore DBB for 3 months 20 hours a day and then went to nights only. He did not tolerate the bar well at all. is the only one of Dr. Latz's patients with his particular malformation. His feet were severe, but could be turned neutral very easily. His foot, however, continues to be in the shape of a " C " due to the strength of the muscule on the inside of his foot. After seeing Dr. Ponseti at 18 months, (he said he had only seen about 3 or 4 cases like 's before) he would walk out of it by age 3 or 4. Dr. Latz wants to do surgery to move the tibial tendon from the medial location on the foot to the middle of the foot. He thinks this will reshape his foot enough to allow him to wear regular shoes his whole life. He wears regular shoes at this time and does not complain. I guess my question is whether anyone else has had this surgery? Please inform me if you have, we are having a hard time deciding what to do. > > Amy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 3, 2003 Report Share Posted January 3, 2003 Hi, Amy! Glad you decided to de-lurk! Your is almost the same age as my daughter, she was born on the 16th of March. I don't know how many parents here have had their child go through the ATTT surgery. might have a better idea of that. I believe that Anandhi's child (who participates on the Parentsplace clubfoot board) had the ATTT, but I don't think she posts here. Has been back to see the doctors in Iowa since he was 18 months old? Perhaps you could arrange another follow up with them since he's older now to see how they think his feet are progressing and get their opinion on trying the surgery. In my opinion, Dr. P is the expert, and I'd trust his opinion first and foremost. I'm not sure if there is an age limit on performing the ATTT, or if there is an advantage of doing it now versus doing it after age 4. I guess if I were in your situation, those would be the questions that I'd want answered. I do know that the tendon transfer surgery is supposed to be a lot less invasive than the PMR surgery. How many of the tendon transfers has your doctor performed? Has he been able to show you before/after photos? I know that they're pretty familiar with the surgery in Iowa and perhaps they could tell you more about it and their experiences. I hope you'll keep us posted on your decisions and let us help support you. Hugs to you- I know how trying these things are- I'm also in the midst of making some treatment decisions about my daughter's foot and will be heading to Iowa in a few weeks. Regards, & (3-16-00) left clubfoot > I have been reading postings for about a year. was treated by Dr. Latz at Children's Mercy in Kansas City, MO. He had a series of 6 castings and tenonomy at 8 weeks. We wore DBB for 3 months 20 hours a day and then went to nights only. He did not tolerate the bar well at all. is the only one of Dr. Latz's patients with his particular malformation. His feet were severe, but could be turned neutral very easily. His foot, however, continues to be in the shape of a " C " due to the strength of the muscule on the inside of his foot. After seeing Dr. Ponseti at 18 months, (he said he had only seen about 3 or 4 cases like 's before) he would walk out of it by age 3 or 4. Dr. Latz wants to do surgery to move the tibial tendon from the medial location on the foot to the middle of the foot. He thinks this will reshape his foot enough to allow him to wear regular shoes his whole life. He wears regular shoes at this time and does not complain. I guess my question is whether anyone else has had this surgery? Please inform me if you have, we are having a hard time deciding what to do. > > Amy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 3, 2003 Report Share Posted January 3, 2003 Amy, I would encourage you to follow Dr. Ponseti's advise or at least to go see him again before you do something else. My guess is that you child has something like residual metatarsus adductus after having been treated for clubfoot. Metatarsus adductus is where the front of the foot turns in, but the heel is still straight not in equinus. In the 1950's, there were doctors who were beginning to do surgeries for metatarsus adductus. Dr. Ponseti wrote a paper in 1966 on metatarsus adductus that indicated that 85% of cases would resolve without any treatment and the remainder only needed limited properly done casting and surgery was almost never required. That paper was well recieved and most surgeries for metatarsus adductus have gone away since then. My impression is that Dr. Ponseti is one of the worlds experts on metatarsus adductus as well as clubfoot. Dr. Ponseti said that it has always been interesting to him that his 1963 paper saying that clubfoot surgery rarely was needed was not accepted by many doctors yet his 1966 paper on metatarsus adductus surgery not being needed was accepted by most other doctors. That 1966 paper was by Ponseti, I.V. and Becker, J.R. " Congenital Metatarsus Adductus: The Results of Treatment. " Journal of Bone & Joint Surgery - American Volume. 43(4): 702-711, 1966 June. and (3-17-99) > I have been reading postings for about a year. was treated by Dr. Latz at Children's Mercy in Kansas City, MO. He had a series of 6 castings and tenonomy at 8 weeks. We wore DBB for 3 months 20 hours a day and then went to nights only. He did not tolerate the bar well at all. is the only one of Dr. Latz's patients with his particular malformation. His feet were severe, but could be turned neutral very easily. His foot, however, continues to be in the shape of a " C " due to the strength of the muscule on the inside of his foot. After seeing Dr. Ponseti at 18 months, (he said he had only seen about 3 or 4 cases like 's before) he would walk out of it by age 3 or 4. Dr. Latz wants to do surgery to move the tibial tendon from the medial location on the foot to the middle of the foot. He thinks this will reshape his foot enough to allow him to wear regular shoes his whole life. He wears regular shoes at this time and does not complain. I guess my question is whether anyone else has had this surgery? Please inform me if you have, we are having a hard time deciding what to do. > > Amy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 3, 2003 Report Share Posted January 3, 2003 Amy, I would encourage you to follow Dr. Ponseti's advise or at least to go see him again before you do something else. My guess is that you child has something like residual metatarsus adductus after having been treated for clubfoot. Metatarsus adductus is where the front of the foot turns in, but the heel is still straight not in equinus. In the 1950's, there were doctors who were beginning to do surgeries for metatarsus adductus. Dr. Ponseti wrote a paper in 1966 on metatarsus adductus that indicated that 85% of cases would resolve without any treatment and the remainder only needed limited properly done casting and surgery was almost never required. That paper was well recieved and most surgeries for metatarsus adductus have gone away since then. My impression is that Dr. Ponseti is one of the worlds experts on metatarsus adductus as well as clubfoot. Dr. Ponseti said that it has always been interesting to him that his 1963 paper saying that clubfoot surgery rarely was needed was not accepted by many doctors yet his 1966 paper on metatarsus adductus surgery not being needed was accepted by most other doctors. That 1966 paper was by Ponseti, I.V. and Becker, J.R. " Congenital Metatarsus Adductus: The Results of Treatment. " Journal of Bone & Joint Surgery - American Volume. 43(4): 702-711, 1966 June. and (3-17-99) > I have been reading postings for about a year. was treated by Dr. Latz at Children's Mercy in Kansas City, MO. He had a series of 6 castings and tenonomy at 8 weeks. We wore DBB for 3 months 20 hours a day and then went to nights only. He did not tolerate the bar well at all. is the only one of Dr. Latz's patients with his particular malformation. His feet were severe, but could be turned neutral very easily. His foot, however, continues to be in the shape of a " C " due to the strength of the muscule on the inside of his foot. After seeing Dr. Ponseti at 18 months, (he said he had only seen about 3 or 4 cases like 's before) he would walk out of it by age 3 or 4. Dr. Latz wants to do surgery to move the tibial tendon from the medial location on the foot to the middle of the foot. He thinks this will reshape his foot enough to allow him to wear regular shoes his whole life. He wears regular shoes at this time and does not complain. I guess my question is whether anyone else has had this surgery? Please inform me if you have, we are having a hard time deciding what to do. > > Amy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 3, 2003 Report Share Posted January 3, 2003 Amy, I would encourage you to follow Dr. Ponseti's advise or at least to go see him again before you do something else. My guess is that you child has something like residual metatarsus adductus after having been treated for clubfoot. Metatarsus adductus is where the front of the foot turns in, but the heel is still straight not in equinus. In the 1950's, there were doctors who were beginning to do surgeries for metatarsus adductus. Dr. Ponseti wrote a paper in 1966 on metatarsus adductus that indicated that 85% of cases would resolve without any treatment and the remainder only needed limited properly done casting and surgery was almost never required. That paper was well recieved and most surgeries for metatarsus adductus have gone away since then. My impression is that Dr. Ponseti is one of the worlds experts on metatarsus adductus as well as clubfoot. Dr. Ponseti said that it has always been interesting to him that his 1963 paper saying that clubfoot surgery rarely was needed was not accepted by many doctors yet his 1966 paper on metatarsus adductus surgery not being needed was accepted by most other doctors. That 1966 paper was by Ponseti, I.V. and Becker, J.R. " Congenital Metatarsus Adductus: The Results of Treatment. " Journal of Bone & Joint Surgery - American Volume. 43(4): 702-711, 1966 June. and (3-17-99) > I have been reading postings for about a year. was treated by Dr. Latz at Children's Mercy in Kansas City, MO. He had a series of 6 castings and tenonomy at 8 weeks. We wore DBB for 3 months 20 hours a day and then went to nights only. He did not tolerate the bar well at all. is the only one of Dr. Latz's patients with his particular malformation. His feet were severe, but could be turned neutral very easily. His foot, however, continues to be in the shape of a " C " due to the strength of the muscule on the inside of his foot. After seeing Dr. Ponseti at 18 months, (he said he had only seen about 3 or 4 cases like 's before) he would walk out of it by age 3 or 4. Dr. Latz wants to do surgery to move the tibial tendon from the medial location on the foot to the middle of the foot. He thinks this will reshape his foot enough to allow him to wear regular shoes his whole life. He wears regular shoes at this time and does not complain. I guess my question is whether anyone else has had this surgery? Please inform me if you have, we are having a hard time deciding what to do. > > Amy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 3, 2003 Report Share Posted January 3, 2003 Amy, My daughter and I are a couple of oldies here on the group but I have not had a chance to post in awhile, but wanted to briefly write about your post. My youngest was born with moderately severe bilateral clubfoot and my oldest was born with mild metatarsus adductus. It was'nt until my oldest was 18 months old that we finally got a referral to a pediatric orthopaedic surgeon to evaluate the intoeing in both of her feet that she had since birth. She was evaluated and we were told she had mild metatarsus in each foot. Her feet turned inward like a " C " shape and she tripped over her feet (one more than the other) all the time when she first started walking.The surgeon told us at that point that she would indeed grow out of it by age 4 and that she might continue to show a slight intoeing after that but not noticable and that it would not cause her any problems in the future. They told us that metatarsus is almost never treated with surgery except in extreme cases that are very rare. I'm not sure if your son fits that catagory or not, but by what Dr. Ponseti had stated to you, it seems that he believes your son would outgrow his condition also even though it is more severe than some he has seen. Our ped ortho told us that reverse laced shoes can be worn also to help the condition which is virtually like a pair of regular shoes worn on the wrong feet. She did not prescribe a pair for our daughter at the time, she was already 18 months old and showing progress as she gained more and more time walking and running. It really was the best " therapy " for her (as it has also been with our clubfoot daughter). Our oldest is now turning 6 years old this month and she does not show any intoeing in either foot anymore. She pretty much grew out of it by age 4 as they said and she has no problems with her feet what so ever except the occasional growing pains in her feet and calves in the middle of the night. I don't know how old your son is, but I do know some doctors tend to be more agressive in their treatments than others. It seems as though a third opinion might be something to think about if you don't feel comfortable with what the first two doctors are telling you. I do have to say thought after a long road with unsucessful treatment for our youngests clubfoot here in Michigan and then meeting and switching to Dr. Ponseti in Iowa, I have developed a stong belief and understanding in Dr. Ponseti's knowlege of the anatomy and development of the human foot. This man truly knows what he is doing. After learning what we were told back when our daughter was diagnosed with M.A. I would be hesitant about surgery for it also. I do know that there is another one of two parents here on the group who have children with M.A. also and had more treatment for it than my daughter, perhaps they can lend some advice also. Holly and BLCF 03-25-00 >I have been reading postings for about a year. was treated by Dr. Latz at Children's Mercy in Kansas City, MO. He had a series of 6 castings and tenonomy at 8 weeks. We wore DBB for 3 months 20 hours a day and then went to nights only. He did not tolerate the bar well at all. is the only one of Dr. Latz's patients with his particular malformation. His feet were severe, but could be turned neutral very easily. His foot, however, continues to be in the shape of a " C " due to the strength of the muscule on the inside of his foot. After seeing Dr. Ponseti at 18 months, (he said he had only seen about 3 or 4 cases like 's before) he would walk out of it by age 3 or 4. Dr. Latz wants to do surgery to move the tibial tendon from the medial location on the foot to the middle of the foot. He thinks this will reshape his foot enough to allow him to wear regular shoes his whole life. He wears regular shoes at this time and does not complain. I guess my question is whether anyone else has had this surgery? Please inform me if you have, we are having a hard time deciding what to do. > >Amy > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 3, 2003 Report Share Posted January 3, 2003 Amy, My daughter and I are a couple of oldies here on the group but I have not had a chance to post in awhile, but wanted to briefly write about your post. My youngest was born with moderately severe bilateral clubfoot and my oldest was born with mild metatarsus adductus. It was'nt until my oldest was 18 months old that we finally got a referral to a pediatric orthopaedic surgeon to evaluate the intoeing in both of her feet that she had since birth. She was evaluated and we were told she had mild metatarsus in each foot. Her feet turned inward like a " C " shape and she tripped over her feet (one more than the other) all the time when she first started walking.The surgeon told us at that point that she would indeed grow out of it by age 4 and that she might continue to show a slight intoeing after that but not noticable and that it would not cause her any problems in the future. They told us that metatarsus is almost never treated with surgery except in extreme cases that are very rare. I'm not sure if your son fits that catagory or not, but by what Dr. Ponseti had stated to you, it seems that he believes your son would outgrow his condition also even though it is more severe than some he has seen. Our ped ortho told us that reverse laced shoes can be worn also to help the condition which is virtually like a pair of regular shoes worn on the wrong feet. She did not prescribe a pair for our daughter at the time, she was already 18 months old and showing progress as she gained more and more time walking and running. It really was the best " therapy " for her (as it has also been with our clubfoot daughter). Our oldest is now turning 6 years old this month and she does not show any intoeing in either foot anymore. She pretty much grew out of it by age 4 as they said and she has no problems with her feet what so ever except the occasional growing pains in her feet and calves in the middle of the night. I don't know how old your son is, but I do know some doctors tend to be more agressive in their treatments than others. It seems as though a third opinion might be something to think about if you don't feel comfortable with what the first two doctors are telling you. I do have to say thought after a long road with unsucessful treatment for our youngests clubfoot here in Michigan and then meeting and switching to Dr. Ponseti in Iowa, I have developed a stong belief and understanding in Dr. Ponseti's knowlege of the anatomy and development of the human foot. This man truly knows what he is doing. After learning what we were told back when our daughter was diagnosed with M.A. I would be hesitant about surgery for it also. I do know that there is another one of two parents here on the group who have children with M.A. also and had more treatment for it than my daughter, perhaps they can lend some advice also. Holly and BLCF 03-25-00 >I have been reading postings for about a year. was treated by Dr. Latz at Children's Mercy in Kansas City, MO. He had a series of 6 castings and tenonomy at 8 weeks. We wore DBB for 3 months 20 hours a day and then went to nights only. He did not tolerate the bar well at all. is the only one of Dr. Latz's patients with his particular malformation. His feet were severe, but could be turned neutral very easily. His foot, however, continues to be in the shape of a " C " due to the strength of the muscule on the inside of his foot. After seeing Dr. Ponseti at 18 months, (he said he had only seen about 3 or 4 cases like 's before) he would walk out of it by age 3 or 4. Dr. Latz wants to do surgery to move the tibial tendon from the medial location on the foot to the middle of the foot. He thinks this will reshape his foot enough to allow him to wear regular shoes his whole life. He wears regular shoes at this time and does not complain. I guess my question is whether anyone else has had this surgery? Please inform me if you have, we are having a hard time deciding what to do. > >Amy > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 3, 2003 Report Share Posted January 3, 2003 Amy, My daughter and I are a couple of oldies here on the group but I have not had a chance to post in awhile, but wanted to briefly write about your post. My youngest was born with moderately severe bilateral clubfoot and my oldest was born with mild metatarsus adductus. It was'nt until my oldest was 18 months old that we finally got a referral to a pediatric orthopaedic surgeon to evaluate the intoeing in both of her feet that she had since birth. She was evaluated and we were told she had mild metatarsus in each foot. Her feet turned inward like a " C " shape and she tripped over her feet (one more than the other) all the time when she first started walking.The surgeon told us at that point that she would indeed grow out of it by age 4 and that she might continue to show a slight intoeing after that but not noticable and that it would not cause her any problems in the future. They told us that metatarsus is almost never treated with surgery except in extreme cases that are very rare. I'm not sure if your son fits that catagory or not, but by what Dr. Ponseti had stated to you, it seems that he believes your son would outgrow his condition also even though it is more severe than some he has seen. Our ped ortho told us that reverse laced shoes can be worn also to help the condition which is virtually like a pair of regular shoes worn on the wrong feet. She did not prescribe a pair for our daughter at the time, she was already 18 months old and showing progress as she gained more and more time walking and running. It really was the best " therapy " for her (as it has also been with our clubfoot daughter). Our oldest is now turning 6 years old this month and she does not show any intoeing in either foot anymore. She pretty much grew out of it by age 4 as they said and she has no problems with her feet what so ever except the occasional growing pains in her feet and calves in the middle of the night. I don't know how old your son is, but I do know some doctors tend to be more agressive in their treatments than others. It seems as though a third opinion might be something to think about if you don't feel comfortable with what the first two doctors are telling you. I do have to say thought after a long road with unsucessful treatment for our youngests clubfoot here in Michigan and then meeting and switching to Dr. Ponseti in Iowa, I have developed a stong belief and understanding in Dr. Ponseti's knowlege of the anatomy and development of the human foot. This man truly knows what he is doing. After learning what we were told back when our daughter was diagnosed with M.A. I would be hesitant about surgery for it also. I do know that there is another one of two parents here on the group who have children with M.A. also and had more treatment for it than my daughter, perhaps they can lend some advice also. Holly and BLCF 03-25-00 >I have been reading postings for about a year. was treated by Dr. Latz at Children's Mercy in Kansas City, MO. He had a series of 6 castings and tenonomy at 8 weeks. We wore DBB for 3 months 20 hours a day and then went to nights only. He did not tolerate the bar well at all. is the only one of Dr. Latz's patients with his particular malformation. His feet were severe, but could be turned neutral very easily. His foot, however, continues to be in the shape of a " C " due to the strength of the muscule on the inside of his foot. After seeing Dr. Ponseti at 18 months, (he said he had only seen about 3 or 4 cases like 's before) he would walk out of it by age 3 or 4. Dr. Latz wants to do surgery to move the tibial tendon from the medial location on the foot to the middle of the foot. He thinks this will reshape his foot enough to allow him to wear regular shoes his whole life. He wears regular shoes at this time and does not complain. I guess my question is whether anyone else has had this surgery? Please inform me if you have, we are having a hard time deciding what to do. > >Amy > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 5, 2003 Report Share Posted January 5, 2003 Hi Amy, My daughter is 3 and her foot is too shape like a " c. " She has metataurus abductus. We were informed by Dr. Ponseti and a orthopedic doctor here, to wait unil Ivy is 4 or 5 before opting for surgery to correct the metatarus abductus. That it generally will correct it self. I have also been told that once a clubfoot, that the foot will always look somewhat " differnt. " I personally can understand... I was born with cleft lip and palate. I have had many surgieries, obvously my lip/palate are corrected, and my speach is excellent. However, I still have the scares of the cleft lip and one can tell that I had a cleft lip/palate. My main concern with my daughter now isn't so much appearance of the foot, but funtion of the foot. (Though is still wonder when she'll grow into the lose skin creases on the side of the foot. ) My main concern would be function. How is your little one functioning with the foot? How is the flexability? Is the ankle involed? Is there pain? etc. Take care, Sara and Ivy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2003 Report Share Posted January 6, 2003 Sara Doesn't complain of pain. Runs with one foot stepping over the other, but compensates well. My husband and I are both very athletic and are concerned that when he's ready to compete, it could inhibit him. Amy & (BLCF 03-25-00) >>> smasoner90@... 01/05/03 02:02AM >>> Hi Amy, My daughter is 3 and her foot is too shape like a " c. " She has metataurus abductus. We were informed by Dr. Ponseti and a orthopedic doctor here, to wait unil Ivy is 4 or 5 before opting for surgery to correct the metatarus abductus. That it generally will correct it self. I have also been told that once a clubfoot, that the foot will always look somewhat " differnt. " I personally can understand... I was born with cleft lip and palate. I have had many surgieries, obvously my lip/palate are corrected, and my speach is excellent. However, I still have the scares of the cleft lip and one can tell that I had a cleft lip/palate. My main concern with my daughter now isn't so much appearance of the foot, but funtion of the foot. (Though is still wonder when she'll grow into the lose skin creases on the side of the foot. ) My main concern would be function. How is your little one functioning with the foot? How is the flexability? Is the ankle involed? Is there pain? etc. Take care, Sara and Ivy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2003 Report Share Posted January 6, 2003 Please tell me about Parentsplace. I would like to talk to more people with MA. I don't want to do surgery, if it is not necessary. Amy & (BLCF 03-25-00) >>> jenrichtrevillian@... 01/03/03 09:48AM >>> Hi, Amy! Glad you decided to de-lurk! Your is almost the same age as my daughter, she was born on the 16th of March. I don't know how many parents here have had their child go through the ATTT surgery. might have a better idea of that. I believe that Anandhi's child (who participates on the Parentsplace clubfoot board) had the ATTT, but I don't think she posts here. Has been back to see the doctors in Iowa since he was 18 months old? Perhaps you could arrange another follow up with them since he's older now to see how they think his feet are progressing and get their opinion on trying the surgery. In my opinion, Dr. P is the expert, and I'd trust his opinion first and foremost. I'm not sure if there is an age limit on performing the ATTT, or if there is an advantage of doing it now versus doing it after age 4. I guess if I were in your situation, those would be the questions that I'd want answered. I do know that the tendon transfer surgery is supposed to be a lot less invasive than the PMR surgery. How many of the tendon transfers has your doctor performed? Has he been able to show you before/after photos? I know that they're pretty familiar with the surgery in Iowa and perhaps they could tell you more about it and their experiences. I hope you'll keep us posted on your decisions and let us help support you. Hugs to you- I know how trying these things are- I'm also in the midst of making some treatment decisions about my daughter's foot and will be heading to Iowa in a few weeks. Regards, & (3-16-00) left clubfoot > I have been reading postings for about a year. was treated by Dr. Latz at Children's Mercy in Kansas City, MO. He had a series of 6 castings and tenonomy at 8 weeks. We wore DBB for 3 months 20 hours a day and then went to nights only. He did not tolerate the bar well at all. is the only one of Dr. Latz's patients with his particular malformation. His feet were severe, but could be turned neutral very easily. His foot, however, continues to be in the shape of a " C " due to the strength of the muscule on the inside of his foot. After seeing Dr. Ponseti at 18 months, (he said he had only seen about 3 or 4 cases like 's before) he would walk out of it by age 3 or 4. Dr. Latz wants to do surgery to move the tibial tendon from the medial location on the foot to the middle of the foot. He thinks this will reshape his foot enough to allow him to wear regular shoes his whole life. He wears regular shoes at this time and does not complain. I guess my question is whether anyone else has had this surgery? Please inform me if you have, we are having a hard time deciding what to do. > > Amy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2003 Report Share Posted January 6, 2003 We are looking into visiting Dr. Ponseti again before making a decision. Thanks for your advice. Amy & (BLCF 03-25-00) >>> martinegbert@... 01/03/03 10:59AM >>> Amy, I would encourage you to follow Dr. Ponseti's advise or at least to go see him again before you do something else. My guess is that you child has something like residual metatarsus adductus after having been treated for clubfoot. Metatarsus adductus is where the front of the foot turns in, but the heel is still straight not in equinus. In the 1950's, there were doctors who were beginning to do surgeries for metatarsus adductus. Dr. Ponseti wrote a paper in 1966 on metatarsus adductus that indicated that 85% of cases would resolve without any treatment and the remainder only needed limited properly done casting and surgery was almost never required. That paper was well recieved and most surgeries for metatarsus adductus have gone away since then. My impression is that Dr. Ponseti is one of the worlds experts on metatarsus adductus as well as clubfoot. Dr. Ponseti said that it has always been interesting to him that his 1963 paper saying that clubfoot surgery rarely was needed was not accepted by many doctors yet his 1966 paper on metatarsus adductus surgery not being needed was accepted by most other doctors. That 1966 paper was by Ponseti, I.V. and Becker, J.R. " Congenital Metatarsus Adductus: The Results of Treatment. " Journal of Bone & Joint Surgery - American Volume. 43(4): 702-711, 1966 June. and (3-17-99) > I have been reading postings for about a year. was treated by Dr. Latz at Children's Mercy in Kansas City, MO. He had a series of 6 castings and tenonomy at 8 weeks. We wore DBB for 3 months 20 hours a day and then went to nights only. He did not tolerate the bar well at all. is the only one of Dr. Latz's patients with his particular malformation. His feet were severe, but could be turned neutral very easily. His foot, however, continues to be in the shape of a " C " due to the strength of the muscule on the inside of his foot. After seeing Dr. Ponseti at 18 months, (he said he had only seen about 3 or 4 cases like 's before) he would walk out of it by age 3 or 4. Dr. Latz wants to do surgery to move the tibial tendon from the medial location on the foot to the middle of the foot. He thinks this will reshape his foot enough to allow him to wear regular shoes his whole life. He wears regular shoes at this time and does not complain. I guess my question is whether anyone else has had this surgery? Please inform me if you have, we are having a hard time deciding what to do. > > Amy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2003 Report Share Posted January 6, 2003 We are looking into visiting Dr. Ponseti again before making a decision. Thanks for your advice. Amy & (BLCF 03-25-00) >>> martinegbert@... 01/03/03 10:59AM >>> Amy, I would encourage you to follow Dr. Ponseti's advise or at least to go see him again before you do something else. My guess is that you child has something like residual metatarsus adductus after having been treated for clubfoot. Metatarsus adductus is where the front of the foot turns in, but the heel is still straight not in equinus. In the 1950's, there were doctors who were beginning to do surgeries for metatarsus adductus. Dr. Ponseti wrote a paper in 1966 on metatarsus adductus that indicated that 85% of cases would resolve without any treatment and the remainder only needed limited properly done casting and surgery was almost never required. That paper was well recieved and most surgeries for metatarsus adductus have gone away since then. My impression is that Dr. Ponseti is one of the worlds experts on metatarsus adductus as well as clubfoot. Dr. Ponseti said that it has always been interesting to him that his 1963 paper saying that clubfoot surgery rarely was needed was not accepted by many doctors yet his 1966 paper on metatarsus adductus surgery not being needed was accepted by most other doctors. That 1966 paper was by Ponseti, I.V. and Becker, J.R. " Congenital Metatarsus Adductus: The Results of Treatment. " Journal of Bone & Joint Surgery - American Volume. 43(4): 702-711, 1966 June. and (3-17-99) > I have been reading postings for about a year. was treated by Dr. Latz at Children's Mercy in Kansas City, MO. He had a series of 6 castings and tenonomy at 8 weeks. We wore DBB for 3 months 20 hours a day and then went to nights only. He did not tolerate the bar well at all. is the only one of Dr. Latz's patients with his particular malformation. His feet were severe, but could be turned neutral very easily. His foot, however, continues to be in the shape of a " C " due to the strength of the muscule on the inside of his foot. After seeing Dr. Ponseti at 18 months, (he said he had only seen about 3 or 4 cases like 's before) he would walk out of it by age 3 or 4. Dr. Latz wants to do surgery to move the tibial tendon from the medial location on the foot to the middle of the foot. He thinks this will reshape his foot enough to allow him to wear regular shoes his whole life. He wears regular shoes at this time and does not complain. I guess my question is whether anyone else has had this surgery? Please inform me if you have, we are having a hard time deciding what to do. > > Amy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2003 Report Share Posted January 6, 2003 Holly- Your experience is what I have been seeking. is turning 3 in March. We do not want to do any surgery that is not necessary. My husband and I are both very athletic. We are concerned that when he is old enough to compete, he will be inhibited by his feet. Granted that may not be a path he chooses, however, we don't want to limit his choices. currently runs with one foot over the other, did you witness this in your child at age 3? I am just wondering if this is normal for this stage of development. Thanks for your input. Amy & (BLCF 03-25-00) >>> dhtru@... 01/03/03 08:14PM >>> Amy, My daughter and I are a couple of oldies here on the group but I have not had a chance to post in awhile, but wanted to briefly write about your post. My youngest was born with moderately severe bilateral clubfoot and my oldest was born with mild metatarsus adductus. It was'nt until my oldest was 18 months old that we finally got a referral to a pediatric orthopaedic surgeon to evaluate the intoeing in both of her feet that she had since birth. She was evaluated and we were told she had mild metatarsus in each foot. Her feet turned inward like a " C " shape and she tripped over her feet (one more than the other) all the time when she first started walking.The surgeon told us at that point that she would indeed grow out of it by age 4 and that she might continue to show a slight intoeing after that but not noticable and that it would not cause her any problems in the future. They told us that metatarsus is almost never treated with surgery except in extreme cases that are very rare. I'm not sure if your son fits that catagory or not, but by what Dr. Ponseti had stated to you, it seems that he believes your son would outgrow his condition also even though it is more severe than some he has seen. Our ped ortho told us that reverse laced shoes can be worn also to help the condition which is virtually like a pair of regular shoes worn on the wrong feet. She did not prescribe a pair for our daughter at the time, she was already 18 months old and showing progress as she gained more and more time walking and running. It really was the best " therapy " for her (as it has also been with our clubfoot daughter). Our oldest is now turning 6 years old this month and she does not show any intoeing in either foot anymore. She pretty much grew out of it by age 4 as they said and she has no problems with her feet what so ever except the occasional growing pains in her feet and calves in the middle of the night. I don't know how old your son is, but I do know some doctors tend to be more agressive in their treatments than others. It seems as though a third opinion might be something to think about if you don't feel comfortable with what the first two doctors are telling you. I do have to say thought after a long road with unsucessful treatment for our youngests clubfoot here in Michigan and then meeting and switching to Dr. Ponseti in Iowa, I have developed a stong belief and understanding in Dr. Ponseti's knowlege of the anatomy and development of the human foot. This man truly knows what he is doing. After learning what we were told back when our daughter was diagnosed with M.A. I would be hesitant about surgery for it also. I do know that there is another one of two parents here on the group who have children with M.A. also and had more treatment for it than my daughter, perhaps they can lend some advice also. Holly and BLCF 03-25-00 >I have been reading postings for about a year. was treated by Dr. Latz at Children's Mercy in Kansas City, MO. He had a series of 6 castings and tenonomy at 8 weeks. We wore DBB for 3 months 20 hours a day and then went to nights only. He did not tolerate the bar well at all. is the only one of Dr. Latz's patients with his particular malformation. His feet were severe, but could be turned neutral very easily. His foot, however, continues to be in the shape of a " C " due to the strength of the muscule on the inside of his foot. After seeing Dr. Ponseti at 18 months, (he said he had only seen about 3 or 4 cases like 's before) he would walk out of it by age 3 or 4. Dr. Latz wants to do surgery to move the tibial tendon from the medial location on the foot to the middle of the foot. He thinks this will reshape his foot enough to allow him to wear regular shoes his whole life. He wears regular shoes at this time and does not complain. I guess my question is whether anyone else has had this surgery? Please inform me if you have, we are having a hard time deciding what to do. > >Amy > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2003 Report Share Posted January 6, 2003 Amy, The parentsplace board can be found at http://www.parentsplace.com/messageboards and then scroll down to the clubfoot board under the " Kids' Health " section. I don't think Anandhi's child had MA, but had the ATTT to treat regression of clubfoot. You should be able to get input on both MA and the ATTT surgery there though. However, I don't think Anandhi checks the boards too often anymore- just so you know. But there is a post there now on the current board (that recently posted) that has a link to Anandhi's old posts about the procedure. Hope this helps, & (3-16-00) left clubfoot > > I have been reading postings for about a year. was treated > by Dr. Latz at Children's Mercy in Kansas City, MO. He had a > series of 6 castings and tenonomy at 8 weeks. We wore DBB for 3 > months 20 hours a day and then went to nights only. He did not > tolerate the bar well at all. is the only one of Dr. Latz's > patients with his particular malformation. His feet were severe, but > could be turned neutral very easily. His foot, however, continues to > be in the shape of a " C " due to the strength of the muscule on the > inside of his foot. After seeing Dr. Ponseti at 18 months, (he said > he had only seen about 3 or 4 cases like 's before) he would > walk out of it by age 3 or 4. Dr. Latz wants to do surgery to move > the tibial tendon from the medial location on the foot to the middle > of the foot. He thinks this will reshape his foot enough to allow > him to wear regular shoes his whole life. He wears regular shoes at > this time and does not complain. I guess my question is whether > anyone else has had this surgery? Please inform me if you have, we > are having a hard time deciding what to do. > > > > Amy > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2003 Report Share Posted January 6, 2003 Amy, I wish I could remember exact ages as to when I stopped noticing tripping, etc. and as much turning in of her feet. She started walking unassisted at 12 months and I remember that from when she really started walking well on her own up until she was 3 or so she had a lot of intoeing. People (friends and strangers) would remark on it to us and ask if we had seen a specialist. Mostly people who had intoeing or some foot problem themselves at a young age. We kept saying yes, and she is supposed to grow out of this but it played on our minds all the time. We were hoping that we had done the right thing by not doing anything at all and taking the advice of the orthopaedic surgeon who told us she indeed would grow out of it. I am going to go through my pictures and try and pinpoint exactly when I noticed the problem had pretty much corrected itself. had a lot of bowlegging as a toddler and her feet turned inward in the mid point of her feet (the metatarsal area) but also in the ankles. So....between all three things, she would trip a lot for quite awhile when she was a toddler. I used to hover over her when she would run because I was always affraid she was going to fall again (especially outside) and hurt herself. She too compensated a lot and learned how to use those feet so she would'nt fall as much. There is a picture in my youngest daughters file of 's feet as an infant. I was trying to show what metatarsus looks like to some other parents on the group once. Look in " 's " file in the " files " section of nosurgery4clubfoot. Scan down and you'll find one picture of 's feet and see how they compare to your son's. By the way, my husband and I were also very concerned when it came to sports. My husband has always been extremely athletic and his girls both take after him. The orthopeadice doctor mentioned to us that it is kind of funny that the kids with the metatarsus in general we will find can run faster than kids without. She did'nt know why but had found it to be true of many of her older, athletic patients. My husband thought that was great! Amazingly enough, my 6 year old, , is an excellent soccor player and can run faster than most of her friends her age. She is in ballet now and that is proving to be a more difficult one for her. She is learning to point those toes outward and it is more difficult for her than the other girls. Those feet just seem a little stiffer than ballet requires.............we'll see though. Nothing has stopped her from doing whatever she wanted before and I'm sure she'll find a way to accomplish this too. Now her little sister, , our clubfoot baby wants to " dance " ballet. At just turned two years old, she could also kick a soccor ball across the yard, so I think she is going to be a lot like her sister in many ways. Amazingly enough, with all of 's foot problems at birth, her feet are straighter than 's ever were at this age (2 but turning 3 in February.) I'll let you know when I look at some pictures and see what I can find. Holly and BLCF 03-25-00 > > >>I have been reading postings for about a year. was treated by Dr. > Latz at Children's Mercy in Kansas City, MO. He had a series of 6 >castings and tenonomy at 8 weeks. We wore DBB for 3 months 20 hours a day >and then went to nights only. He did not tolerate the bar well at all. > is the only one of Dr. Latz's patients with his particular >malformation. His feet were severe, but could be turned neutral very >easily. His foot, however, continues to be in the shape of a " C " due to >the strength of the muscule on the inside of his foot. After seeing Dr. >Ponseti at 18 months, (he said he had only seen about 3 or 4 cases like >'s before) he would walk out of it by age 3 or 4. Dr. Latz wants to >do surgery to move the tibial tendon from the medial location on the foot to >the middle of the foot. He thinks this will reshape his foot enough to >allow him to wear regular shoes his whole life. He wears regular shoes at >this time and does not complain. I guess my question is whether anyone else >has had this surgery? Please inform me if you have, we are having a hard >time deciding what to do. >> >>Amy >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 7, 2003 Report Share Posted January 7, 2003 Holly Your information has reinforced what we think we are going to do. We are going to see Dr. Ponseti on Friday and make a final decision. I will check out those pictures today. I will have to admit I am very excited that its highly likely we can skip the ATTT surgery. In my opinion, the less invasive the treatment the better. We are going to try karate with this spring (3 on March 25th). We've heard that things like ballet and karate etc can really be beneficial to club feet children. Thanks so much for your input Amy and (BLCF 03-25-00) >>> dhtru@... 01/06/03 09:38PM >>> Amy, I wish I could remember exact ages as to when I stopped noticing tripping, etc. and as much turning in of her feet. She started walking unassisted at 12 months and I remember that from when she really started walking well on her own up until she was 3 or so she had a lot of intoeing. People (friends and strangers) would remark on it to us and ask if we had seen a specialist. Mostly people who had intoeing or some foot problem themselves at a young age. We kept saying yes, and she is supposed to grow out of this but it played on our minds all the time. We were hoping that we had done the right thing by not doing anything at all and taking the advice of the orthopaedic surgeon who told us she indeed would grow out of it. I am going to go through my pictures and try and pinpoint exactly when I noticed the problem had pretty much corrected itself. had a lot of bowlegging as a toddler and her feet turned inward in the mid point of her feet (the metatarsal area) but also in the ankles. So....between all three things, she would trip a lot for quite awhile when she was a toddler. I used to hover over her when she would run because I was always affraid she was going to fall again (especially outside) and hurt herself. She too compensated a lot and learned how to use those feet so she would'nt fall as much. There is a picture in my youngest daughters file of 's feet as an infant. I was trying to show what metatarsus looks like to some other parents on the group once. Look in " 's " file in the " files " section of nosurgery4clubfoot. Scan down and you'll find one picture of 's feet and see how they compare to your son's. By the way, my husband and I were also very concerned when it came to sports. My husband has always been extremely athletic and his girls both take after him. The orthopeadice doctor mentioned to us that it is kind of funny that the kids with the metatarsus in general we will find can run faster than kids without. She did'nt know why but had found it to be true of many of her older, athletic patients. My husband thought that was great! Amazingly enough, my 6 year old, , is an excellent soccor player and can run faster than most of her friends her age. She is in ballet now and that is proving to be a more difficult one for her. She is learning to point those toes outward and it is more difficult for her than the other girls. Those feet just seem a little stiffer than ballet requires.............we'll see though. Nothing has stopped her from doing whatever she wanted before and I'm sure she'll find a way to accomplish this too. Now her little sister, , our clubfoot baby wants to " dance " ballet. At just turned two years old, she could also kick a soccor ball across the yard, so I think she is going to be a lot like her sister in many ways. Amazingly enough, with all of 's foot problems at birth, her feet are straighter than 's ever were at this age (2 but turning 3 in February.) I'll let you know when I look at some pictures and see what I can find. Holly and BLCF 03-25-00 > > >>I have been reading postings for about a year. was treated by Dr. > Latz at Children's Mercy in Kansas City, MO. He had a series of 6 >castings and tenonomy at 8 weeks. We wore DBB for 3 months 20 hours a day >and then went to nights only. He did not tolerate the bar well at all. > is the only one of Dr. Latz's patients with his particular >malformation. His feet were severe, but could be turned neutral very >easily. His foot, however, continues to be in the shape of a " C " due to >the strength of the muscule on the inside of his foot. After seeing Dr. >Ponseti at 18 months, (he said he had only seen about 3 or 4 cases like >'s before) he would walk out of it by age 3 or 4. Dr. Latz wants to >do surgery to move the tibial tendon from the medial location on the foot to >the middle of the foot. He thinks this will reshape his foot enough to >allow him to wear regular shoes his whole life. He wears regular shoes at >this time and does not complain. I guess my question is whether anyone else >has had this surgery? Please inform me if you have, we are having a hard >time deciding what to do. >> >>Amy >> >> >> Quote Link to comment Share on other sites More sharing options...
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