Guest guest Posted March 3, 2004 Report Share Posted March 3, 2004 Hi my son is 3 months old, has bilateral clubfeet and has gone thru the casting and tenotomy part of the treatment and got his DBBs on Monday. Can you please answer my questions. 1. Potentially a bit daft but is there any easy way of telling whether his heal is in the boot? I slide my finger down the side but then he's out of the boot before you can say jack rabbit so am a bit stuck. 2. There is a guage on the boots but I can't see what that is measured against to identify what angle the boots have been set against - this seems mad to me - can you please tell me what the gauge is read against. 3. His feet have gone round find but inside of the foot is higher than the outside by about 40 degrees - do the boots correct this? 4. His little toes on one side were accidentally plastered under his foot. The last cast improved them (well moved them back up) but am not sure they are right - I've been told they'll be fine - does anyone have any views ie will they go back by wearing the boots? 5. How do I know wheter the boots are the right size 6. absolutely hates the boots and manages to get his feet out - is there anything I can do please? Sorry for so many questions, am sure you understand. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2004 Report Share Posted March 3, 2004 >>1. Potentially a bit daft but is there any easy way of telling whether his heal is in the boot? I slide my finger down the side but then he's out of the boot before you can say jack rabbit so am a bit stuck.>> We were told a good way to tell: Put the foot in the shoe, pull on the toe of the socks to bring the foot fully forward, do your straps and laces, then firmly grasp the shoe with one hand and the leg with the other and pull up and down. If the toes move back and forth, the the foot is not solidly in the shoe, if they dont budge, you are fine. >>2. There is a guage on the boots but I can't see what that is measured against to identify what angle the boots have been set against - this seems mad to me - can you please tell me what the gauge is read against.>> If you have and adjustable Fillauer bar - which is red - (see photos under Trevellian for example) then the measure line is directly perpendicular to the bar thru the middle of the screw. If you hold a straight object in a T thu the middle of the screw it should give you a really good idea of the degree. You can also use a protractor to draw the proper degree and measure it against the angle the shoe makes. On the non-adjustable bars - which are a variety of colors - each notch is approximately 5 degrees and there is a line on the end of the bar that will coincide with one of the notches. I dont know about the Markell adjustable bar. >>3. His feet have gone round find but inside of the foot is higher than the outside by about 40 degrees - do the boots correct this?>> Not sure of your meaning here ... do you mean that he has a high arch? >>4. His little toes on one side were accidentally plastered under his foot. The last cast improved them (well moved them back up) but am not sure they are right - I've been told they'll be fine - does anyone have any views ie will they go back by wearing the boots?>> This is probably a wait and see sort of thing ... they will probably readjust themselves just fine now that they are no longer tucked under. >>5. How do I know wheter the boots are the right size>> Try this link: http://f2.grp.yahoofs.com/v1/gHFGQLTk5iNUTNOKc_YtzKD-XTlaXe2KMvLyKx-Faf1BHIhIonX\ izA-BfOG3AsOESqymSMx0sdzQs4UKgcoQVqEVPo40xJxARw/New%20Markell%20Shoe%20Literatur\ e/PonsetiBrochure.pdf If that does not work, go to the files section and locate the file " New Markell Shoe Lit " and the PDF will come up. >>6. absolutely hates the boots and manages to get his feet out - is there anything I can do please?>> Again, check out the files section here - there should be a whole file by castlady on this subject. He will get used to them in a few days, and if he does not then you need to explore the possibility that his feet and not fully corrected. Angel Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2004 Report Share Posted March 3, 2004 Hello , If you are not yet a member of the group, join so that you can access the files section. Read all the files which are under " shoes " by castlady from 1/25/03. These will be very helpful. If you still are having trouble, just let us know! Adjusting to the DBB was probably the hardest time for us. Hang in there, it will all work out! Bethany > Hi my son is 3 months old, has bilateral clubfeet and has > gone thru the casting and tenotomy part of the treatment and got his > DBBs on Monday. > > Can you please answer my questions. > > 1. Potentially a bit daft but is there any easy way of telling > whether his heal is in the boot? I slide my finger down the side but > then he's out of the boot before you can say jack rabbit so am a bit > stuck. > > 2. There is a guage on the boots but I can't see what that is > measured against to identify what angle the boots have been set > against - this seems mad to me - can you please tell me what the > gauge is read against. > > 3. His feet have gone round find but inside of the foot is higher > than the outside by about 40 degrees - do the boots correct this? > > 4. His little toes on one side were accidentally plastered under his > foot. The last cast improved them (well moved them back up) but am > not sure they are right - I've been told they'll be fine - does > anyone have any views ie will they go back by wearing the boots? > > 5. How do I know wheter the boots are the right size > > 6. absolutely hates the boots and manages to get his feet > out - is there anything I can do please? > > Sorry for so many questions, am sure you understand. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 4, 2004 Report Share Posted March 4, 2004 I'd just like to clarify question number 3. If you hold up so that he bears weight on his feet, do his feet sit flat on the floor or is he bearing weight on the outer edges of the feet? If he bears weight on the outer edges of the feet rather than plant them flat, it's possible that the feet may not be fully corrected. Before your next appointment with his doctor, write all of your concerns down on paper so that you can be sure to ask about all of them...at the actual appointment, it's so easy to get side-tracked and forget about the points you wanted to make during the appointment unless you've got them written down and right in front of you! Good luck and keep us posted. Daiga and Owen, 02/04/03 Unilateral LCF, DBB 14/24 > Hi my son is 3 months old, has bilateral clubfeet and has > gone thru the casting and tenotomy part of the treatment and got his > DBBs on Monday. > > Can you please answer my questions. > > 1. Potentially a bit daft but is there any easy way of telling > whether his heal is in the boot? I slide my finger down the side but > then he's out of the boot before you can say jack rabbit so am a bit > stuck. > > 2. There is a guage on the boots but I can't see what that is > measured against to identify what angle the boots have been set > against - this seems mad to me - can you please tell me what the > gauge is read against. > > 3. His feet have gone round find but inside of the foot is higher > than the outside by about 40 degrees - do the boots correct this? > > 4. His little toes on one side were accidentally plastered under his > foot. The last cast improved them (well moved them back up) but am > not sure they are right - I've been told they'll be fine - does > anyone have any views ie will they go back by wearing the boots? > > 5. How do I know wheter the boots are the right size > > 6. absolutely hates the boots and manages to get his feet > out - is there anything I can do please? > > Sorry for so many questions, am sure you understand. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 9, 2004 Report Share Posted March 9, 2004 It sounds like you got a lot of sound advice. If I were you I think I might take some photo's of my child's feet and email them to Dr. Ponseti himself. I can't remember the his email addy off hand. I would also look into getting another Dr. I too had a Dr. who told me he was doing the Ponseti method and he was not. You should see dramatic improvement with Ponseti method correction. That is why I am so glad I switched Dr.'s. I can now look at my son's feet and they look almost the same. He still needs to wear the DBB so not to relapse. As far as the toes go I would also ask Dr. Ponseti about this. He may have some better advice than the rest of us here on the boards. I am sorry I could not be more helpful. I don't usually get time to post. I usually only have time to read the posts. Good Luck and good progress LaRena Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 9, 2004 Report Share Posted March 9, 2004 Thanks for all the replies these have been very helpful. Sorry it has taken me a day or two to reply. " If you hold up so that he bears weight on his feet, do his feet sit flat on the floor or is he bearing weight on the outer edges of the feet? " Yes he is weight bearing on the outer edges of his feet. I have raised this several times but the Consultant has said that they are ok and that the boots will complete the correction - I'm not very happy with this as obviously I'm no expert but they don't seem right to me. This was the reason for this question to the group. Friday we went back to the hospital and it was confirmed that 's boots are too big. So a new pair have been ordered and will hopefully be in this week. The current pair have had some padding added but the minute he decides to wriggle out of them he really doesn't have a lot of trouble, equally if carried they tend to drop off too. This is a bit of a nightmare as he gets a foot wedges at an angle and this is naturally very painful. We also saw the physio when there and I now have exercises which will help reduce his foot inversion (I now know the technical term!). It was explained to me that this is due to outer muscles being too long and inner ones being too short which is obvious really but this explanation helped anyway as I hadn't thought of it in those terms. So am now taking his boots off each nappy change and doing 3 exercises - tickle outer underside edge; stroking the outside of the legs and giving him heel stretches. Are there any others I should be doing at this time? How long can the boots be left off? Your advice to pull the toe of the socks made me smile purely because I can see his toes as they are under the flap. I've checked the angle and this is fine - thanks Bad news about his two toes - they seem to be going back under the foot so am going to have to do something about this after all. Some thought needs to go into this and that is tomorrows job. Thanks again Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 9, 2004 Report Share Posted March 9, 2004 , I urge you to seek a second opinion by another Ponseti trained physician. The boots are NOT intended to finish correction. The feet are supposed to be FULLY corrected before entering the boots. Anything less will be uncomfortable and cause problems. As for excercises ... most have never had to use these with their children because their feet were fully corrected in the first place. Those few of us that do have to do stretching or excercises are dealing with things other than basic clubfoot. I hope this helps you some, Angel Re: DBB's query Thanks for all the replies these have been very helpful. Sorry it has taken me a day or two to reply. " If you hold up so that he bears weight on his feet, do his feet sit flat on the floor or is he bearing weight on the outer edges of the feet? " Yes he is weight bearing on the outer edges of his feet. I have raised this several times but the Consultant has said that they are ok and that the boots will complete the correction - I'm not very happy with this as obviously I'm no expert but they don't seem right to me. This was the reason for this question to the group. Friday we went back to the hospital and it was confirmed that 's boots are too big. So a new pair have been ordered and will hopefully be in this week. The current pair have had some padding added but the minute he decides to wriggle out of them he really doesn't have a lot of trouble, equally if carried they tend to drop off too. This is a bit of a nightmare as he gets a foot wedges at an angle and this is naturally very painful. We also saw the physio when there and I now have exercises which will help reduce his foot inversion (I now know the technical term!). It was explained to me that this is due to outer muscles being too long and inner ones being too short which is obvious really but this explanation helped anyway as I hadn't thought of it in those terms. So am now taking his boots off each nappy change and doing 3 exercises - tickle outer underside edge; stroking the outside of the legs and giving him heel stretches. Are there any others I should be doing at this time? How long can the boots be left off? Your advice to pull the toe of the socks made me smile purely because I can see his toes as they are under the flap. I've checked the angle and this is fine - thanks Bad news about his two toes - they seem to be going back under the foot so am going to have to do something about this after all. Some thought needs to go into this and that is tomorrows job. Thanks again Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2004 Report Share Posted March 10, 2004 , if your 'gut instinct' is that the feet do not look right, more likely than not, you are right! The boots will NOT complete the correction. In the Ponseti method, the feet are to be fully corrected before going into the DBB. Here's a quick test to try: 1) Hold the foot out in front of you by grasping the back of the lower leg (do this facing your child, perhaps with him laying on his back) 2) Using your other hand, run your fingertip down the centre of the sole of his foot from back to front. The natural reflex should be that he flexes all of his toes upward - note that ALL of the toes should flex together. If you notice that only some of the toes (ie., the big toe and the one next to it) flex, this can be an indicator that his foot is not fully corrected. I was in your shoes about 8 months ago. With encouragement from the people on this list, I emailed photos to Dr. Ponseti (3 photos - a front, back and side view of him bearing weight on his feet) and recieved a phone call from him the very next day! He confirmed what I'd feared - that Owen's foot was not fully corrected. From there, I took Owen to a Ponseti approved doctor who was able to complete the correction with just one cast. You can email Dr. Ponseti at: Telephone: (319)356-3469 Address: University of Iowa Hospitals and Clinics 200 Hawkins Drive 010255 JPP Iowa City, IA 52242 Via E-mail: ignacio-ponseti@... Good luck and keep us posted! Daiga and Owen, 02/04/03 Unilateral LCF, DBB 14/24 Quote Link to comment Share on other sites More sharing options...
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