tendon transfer?

[Guest guest]

Hi, I am new to this web site. My son was born with club

foot of his right foot. The pediatrician referred us to a

Podiatrist. After a couple of visits, and further research into the

Ponseti method of casting, I noticed that instead of gentle

manipulations, she was forcing the foot into a postion and allowing

the plaster cast to dry. I questioned whether she was familiar with

Ponseti, and she didn't know who that was. At that time I started

challenging my insurance to get a referral to an Orthopedic Surgeon

at Cedar Sinai Hospital in Los Angeles, California. We were

successful and I have been very happy with this doctor, however he

indicated today at my sons check up, that he is going to recommend a

tendon transfer. My son is 18 months old, and has a tendancy to walk

on the outside of his foot, also, he still has cavus, which is the

reason for the surgical approach. I am wondering if the cavus is

still there because of the improper manipulations and casting in the

early days, and whether that can be corrected with the DBB over

time. He has been wearing the DBB at night and naps. He is able to

pull his foot out though which is a problem. My question to any of

you, should I reject the surgery? I do not want to do anything

drastic that will harm him, but I am afraid that further bracing

won't fix these problems and he won't walk correctly when he is

older. I would appreciate any advise that I can get or further

information on this subject.

Thank you.

[Guest guest]

,

Welcome to the site. I would recommend that you contact Dr. Colburn

immediately and try to get in for a consultation ASAP. (if you can,

try to get it in despite insurance...you can fight for coverage later

if need be) He is the doctor with the most experience using the

Ponseti method on the west coast and will give you the best advice on

your son's treatment options at this point. I urge you to act

quickly since your son is 18 months already. You can get Dr.

Colburn's contact information off Dr. P's website. Ask to speak to

his nurse, don't just make an appointment through the receptionist,

or it will take longer to get your son in.

If you're unable to travel to Dr. Colburn's office, perhaps he could

recommend a doctor nearer to you. I know he'll consult with you over

the phone if you're unable to get there.

Keep us posted!

& (3-16-00)

left clubfoot

http://ponseticlubfoot.freeservers.com/

> Hi, I am new to this web site. My son was born with club

> foot of his right foot. The pediatrician referred us to a

> Podiatrist. After a couple of visits, and further research into the

> Ponseti method of casting, I noticed that instead of gentle

> manipulations, she was forcing the foot into a postion and allowing

> the plaster cast to dry. I questioned whether she was familiar with

> Ponseti, and she didn't know who that was. At that time I started

> challenging my insurance to get a referral to an Orthopedic Surgeon

> at Cedar Sinai Hospital in Los Angeles, California. We were

> successful and I have been very happy with this doctor, however he

> indicated today at my sons check up, that he is going to recommend

a

> tendon transfer. My son is 18 months old, and has a tendancy to

walk

> on the outside of his foot, also, he still has cavus, which is the

> reason for the surgical approach. I am wondering if the cavus is

> still there because of the improper manipulations and casting in

the

> early days, and whether that can be corrected with the DBB over

> time. He has been wearing the DBB at night and naps. He is able to

> pull his foot out though which is a problem. My question to any of

> you, should I reject the surgery? I do not want to do anything

> drastic that will harm him, but I am afraid that further bracing

> won't fix these problems and he won't walk correctly when he is

> older. I would appreciate any advise that I can get or further

> information on this subject.

> Thank you.

[Guest guest]

,

I would urge you to take photos and send them to Dr Ponseti before going forth

with surgery. I do not doubt your doctor's capability, however, there is a

possibility that there may be another approach to correcting his foot without

surgery.

My son has a specific variation of clubfoot that includes frequently relapsing

cavus. He is 15 months and in his 3rd set of casts. Dr. Ponseti indicated to

me just today via e-mail that surgery in his case likely would be no better, and

possibly worse, than the avenue of treatment we are now using. After casting to

correct the cavus, my son will go into shoes that Dr Ponseti has custom made in

Iowa City for feet like this.

While I am in no way saying that your son has the same thing as mine, it may be

that the same sort of treatment would work just as well for him. Dr Ponseti is

always happy to answer questions from parents who are feeling unsure or just

want a second opinion.

Angel

tendon transfer?

Hi, I am new to this web site. My son was born with club

foot of his right foot. The pediatrician referred us to a

Podiatrist. After a couple of visits, and further research into the

Ponseti method of casting, I noticed that instead of gentle

manipulations, she was forcing the foot into a postion and allowing

the plaster cast to dry. I questioned whether she was familiar with

Ponseti, and she didn't know who that was. At that time I started

challenging my insurance to get a referral to an Orthopedic Surgeon

at Cedar Sinai Hospital in Los Angeles, California. We were

successful and I have been very happy with this doctor, however he

indicated today at my sons check up, that he is going to recommend a

tendon transfer. My son is 18 months old, and has a tendancy to walk

on the outside of his foot, also, he still has cavus, which is the

reason for the surgical approach. I am wondering if the cavus is

still there because of the improper manipulations and casting in the

early days, and whether that can be corrected with the DBB over

time. He has been wearing the DBB at night and naps. He is able to

pull his foot out though which is a problem. My question to any of

you, should I reject the surgery? I do not want to do anything

drastic that will harm him, but I am afraid that further bracing

won't fix these problems and he won't walk correctly when he is

older. I would appreciate any advise that I can get or further

information on this subject.

Thank you.

[Guest guest]

Angel,

Thank you so much for your input. Does your son also walk on the outside of

his foot? I will e-mail some pix to Dr. Ponseti. It is comforting to have

people such as you to discuss these issues with. I will keep you posted.

Sincerely

_____

From: kitaki

Sent: Friday, March 19, 2004 9:04 PM

To: nosurgery4clubfoot

Subject: Re: tendon transfer?

,

I would urge you to take photos and send them to Dr Ponseti before going

forth with surgery. I do not doubt your doctor's capability, however, there

is a possibility that there may be another approach to correcting his foot

without surgery.

My son has a specific variation of clubfoot that includes frequently

relapsing cavus. He is 15 months and in his 3rd set of casts. Dr. Ponseti

indicated to me just today via e-mail that surgery in his case likely would

be no better, and possibly worse, than the avenue of treatment we are now

using. After casting to correct the cavus, my son will go into shoes that

Dr Ponseti has custom made in Iowa City for feet like this.

While I am in no way saying that your son has the same thing as mine, it may

be that the same sort of treatment would work just as well for him. Dr

Ponseti is always happy to answer questions from parents who are feeling

unsure or just want a second opinion.

Angel

tendon transfer?

Hi, I am new to this web site. My son was born with club

foot of his right foot. The pediatrician referred us to a

Podiatrist. After a couple of visits, and further research into the

Ponseti method of casting, I noticed that instead of gentle

manipulations, she was forcing the foot into a postion and allowing

the plaster cast to dry. I questioned whether she was familiar with

Ponseti, and she didn't know who that was. At that time I started

challenging my insurance to get a referral to an Orthopedic Surgeon

at Cedar Sinai Hospital in Los Angeles, California. We were

successful and I have been very happy with this doctor, however he

indicated today at my sons check up, that he is going to recommend a

tendon transfer. My son is 18 months old, and has a tendancy to walk

on the outside of his foot, also, he still has cavus, which is the

reason for the surgical approach. I am wondering if the cavus is

still there because of the improper manipulations and casting in the

early days, and whether that can be corrected with the DBB over

time. He has been wearing the DBB at night and naps. He is able to

pull his foot out though which is a problem. My question to any of

you, should I reject the surgery? I do not want to do anything

drastic that will harm him, but I am afraid that further bracing

won't fix these problems and he won't walk correctly when he is

older. I would appreciate any advise that I can get or further

information on this subject.

Thank you.

[Guest guest]

,

Thank you so much for your advice. I looked at the list of doctors on the

site, and also saw a doctor in San Diego, and Woodland hills. I will

definitely seek other opinions, as I don't want to make any hasty decisions;

my son has to live with his foot for the rest of his life.

Sincerely,

_____

From: & Rich

Sent: Friday, March 19, 2004 6:11 PM

To: nosurgery4clubfoot

Subject: Re: tendon transfer?

,

Welcome to the site. I would recommend that you contact Dr. Colburn

immediately and try to get in for a consultation ASAP. (if you can,

try to get it in despite insurance...you can fight for coverage later

if need be) He is the doctor with the most experience using the

Ponseti method on the west coast and will give you the best advice on

your son's treatment options at this point. I urge you to act

quickly since your son is 18 months already. You can get Dr.

Colburn's contact information off Dr. P's website. Ask to speak to

his nurse, don't just make an appointment through the receptionist,

or it will take longer to get your son in.

If you're unable to travel to Dr. Colburn's office, perhaps he could

recommend a doctor nearer to you. I know he'll consult with you over

the phone if you're unable to get there.

Keep us posted!

& (3-16-00)

left clubfoot

http://ponseticlubfoot.freeservers.com/

> Hi, I am new to this web site. My son was born with club

> foot of his right foot. The pediatrician referred us to a

> Podiatrist. After a couple of visits, and further research into the

> Ponseti method of casting, I noticed that instead of gentle

> manipulations, she was forcing the foot into a postion and allowing

> the plaster cast to dry. I questioned whether she was familiar with

> Ponseti, and she didn't know who that was. At that time I started

> challenging my insurance to get a referral to an Orthopedic Surgeon

> at Cedar Sinai Hospital in Los Angeles, California. We were

> successful and I have been very happy with this doctor, however he

> indicated today at my sons check up, that he is going to recommend

a

> tendon transfer. My son is 18 months old, and has a tendancy to

walk

> on the outside of his foot, also, he still has cavus, which is the

> reason for the surgical approach. I am wondering if the cavus is

> still there because of the improper manipulations and casting in

the

> early days, and whether that can be corrected with the DBB over

> time. He has been wearing the DBB at night and naps. He is able to

> pull his foot out though which is a problem. My question to any of

> you, should I reject the surgery? I do not want to do anything

> drastic that will harm him, but I am afraid that further bracing

> won't fix these problems and he won't walk correctly when he is

> older. I would appreciate any advise that I can get or further

> information on this subject.

> Thank you.

[Guest guest]

,

Yes, when in relapse he does sort of walk on the outside of his foot. I think

gave you very good advice about getting ahold of Dr. Colburn. He is

familiar with casting for cavus relapse. I have spoken with him via e-mail on

the subject. I understand he has successfully treated several cases like my

son's without surgery. Like I said before, your son may not have the same

thing, but if it is similar to what Kai has, it may well be manageable with

casting and shoes.

Also, if you sign up for CFPics (

http://health.groups.yahoo.com/group/CFPics/?yguid=162983797 ) which is

maintained by a member of this groups for the express purpose of photos, you can

view photos of Kai's foot and a little girl named Chelsea that both have

problems with cavus. Bothe are in the photos section.

Angel

tendon transfer?

Hi, I am new to this web site. My son was born with club

foot of his right foot. The pediatrician referred us to a

Podiatrist. After a couple of visits, and further research into the

Ponseti method of casting, I noticed that instead of gentle

manipulations, she was forcing the foot into a postion and allowing

the plaster cast to dry. I questioned whether she was familiar with

Ponseti, and she didn't know who that was. At that time I started

challenging my insurance to get a referral to an Orthopedic Surgeon

at Cedar Sinai Hospital in Los Angeles, California. We were

successful and I have been very happy with this doctor, however he

indicated today at my sons check up, that he is going to recommend a

tendon transfer. My son is 18 months old, and has a tendancy to walk

on the outside of his foot, also, he still has cavus, which is the

reason for the surgical approach. I am wondering if the cavus is

still there because of the improper manipulations and casting in the

early days, and whether that can be corrected with the DBB over

time. He has been wearing the DBB at night and naps. He is able to

pull his foot out though which is a problem. My question to any of

you, should I reject the surgery? I do not want to do anything

drastic that will harm him, but I am afraid that further bracing

won't fix these problems and he won't walk correctly when he is

older. I would appreciate any advise that I can get or further

information on this subject.

Thank you.

[Guest guest]

Thank you for the info. I signed up for that site as well, I will

get an e-mail when it is approved. Thanks again.

> ,

>

> Yes, when in relapse he does sort of walk on the outside of his

foot. I think gave you very good advice about getting ahold

of Dr. Colburn. He is familiar with casting for cavus relapse. I

have spoken with him via e-mail on the subject. I understand he has

successfully treated several cases like my son's without surgery.

Like I said before, your son may not have the same thing, but if it

is similar to what Kai has, it may well be manageable with casting

and shoes.

>

> Also, if you sign up for CFPics (

http://health.groups.yahoo.com/group/CFPics/?yguid=162983797 ) which

is maintained by a member of this groups for the express purpose of

photos, you can view photos of Kai's foot and a little girl named

Chelsea that both have problems with cavus. Bothe are in the photos

section.

>

> Angel

>

> tendon transfer?

>

>

> Hi, I am new to this web site. My son was born with club

> foot of his right foot. The pediatrician referred us to a

> Podiatrist. After a couple of visits, and further research into

the

> Ponseti method of casting, I noticed that instead of gentle

> manipulations, she was forcing the foot into a postion and

allowing

> the plaster cast to dry. I questioned whether she was familiar

with

> Ponseti, and she didn't know who that was. At that time I started

> challenging my insurance to get a referral to an Orthopedic

Surgeon

> at Cedar Sinai Hospital in Los Angeles, California. We were

> successful and I have been very happy with this doctor, however he

> indicated today at my sons check up, that he is going to recommend

a

> tendon transfer. My son is 18 months old, and has a tendancy to

walk

> on the outside of his foot, also, he still has cavus, which is the

> reason for the surgical approach. I am wondering if the cavus is

> still there because of the improper manipulations and casting in

the

> early days, and whether that can be corrected with the DBB over

> time. He has been wearing the DBB at night and naps. He is able to

> pull his foot out though which is a problem. My question to any of

> you, should I reject the surgery? I do not want to do anything

> drastic that will harm him, but I am afraid that further bracing

> won't fix these problems and he won't walk correctly when he is

> older. I would appreciate any advise that I can get or further

> information on this subject.

> Thank you.

>

>

>

>

>

[Guest guest]

Hi again,

Question for you, are you in Iowa, or do you travel there?

_____

From: kitaki

Sent: Friday, March 19, 2004 9:04 PM

To: nosurgery4clubfoot

Subject: Re: tendon transfer?

,

I would urge you to take photos and send them to Dr Ponseti before going

forth with surgery. I do not doubt your doctor's capability, however, there

is a possibility that there may be another approach to correcting his foot

without surgery.

My son has a specific variation of clubfoot that includes frequently

relapsing cavus. He is 15 months and in his 3rd set of casts. Dr. Ponseti

indicated to me just today via e-mail that surgery in his case likely would

be no better, and possibly worse, than the avenue of treatment we are now

using. After casting to correct the cavus, my son will go into shoes that

Dr Ponseti has custom made in Iowa City for feet like this.

While I am in no way saying that your son has the same thing as mine, it may

be that the same sort of treatment would work just as well for him. Dr

Ponseti is always happy to answer questions from parents who are feeling

unsure or just want a second opinion.

Angel

tendon transfer?

Hi, I am new to this web site. My son was born with club

foot of his right foot. The pediatrician referred us to a

Podiatrist. After a couple of visits, and further research into the

Ponseti method of casting, I noticed that instead of gentle

manipulations, she was forcing the foot into a postion and allowing

the plaster cast to dry. I questioned whether she was familiar with

Ponseti, and she didn't know who that was. At that time I started

challenging my insurance to get a referral to an Orthopedic Surgeon

at Cedar Sinai Hospital in Los Angeles, California. We were

successful and I have been very happy with this doctor, however he

indicated today at my sons check up, that he is going to recommend a

tendon transfer. My son is 18 months old, and has a tendancy to walk

on the outside of his foot, also, he still has cavus, which is the

reason for the surgical approach. I am wondering if the cavus is

still there because of the improper manipulations and casting in the

early days, and whether that can be corrected with the DBB over

time. He has been wearing the DBB at night and naps. He is able to

pull his foot out though which is a problem. My question to any of

you, should I reject the surgery? I do not want to do anything

drastic that will harm him, but I am afraid that further bracing

won't fix these problems and he won't walk correctly when he is

older. I would appreciate any advise that I can get or further

information on this subject.

Thank you.

[Guest guest]

Oh, if only I were! lol No, last September I flew from Seattle to Iowa after

it was determined that our doctor in Seattle (Dr Mosca) did not know what he was

dealing with in this unusual foot. I stayed in Iowa City 8 days. Since that

time, Dr. Mosca has kept in very close touch with Dr Ponseti about feet like

Kai's as he currently has 4-5 patients with this unusual cavus. In fact,

another member here - kitegirl () has a daughter with the same thing, and

thanks to the information flow between Dr. Mosca and Dr. Ponseti since I

traveled there, she was able to avoid the trip to Iowa.

Dr Mosca has been doing this last set of casting for us - we do day trips from

where we live in central WA to Seattle every 2 weeks - but Dr. Ponseti is doing

his best to gather as much info as he can about the condition, so we keep in

close touch with him via e-mail.

If you would like, you can e-mail me off board at m_kitaki@... .

Angel

tendon transfer?

Hi, I am new to this web site. My son was born with club

foot of his right foot. The pediatrician referred us to a

Podiatrist. After a couple of visits, and further research into the

Ponseti method of casting, I noticed that instead of gentle

manipulations, she was forcing the foot into a postion and allowing

the plaster cast to dry. I questioned whether she was familiar with

Ponseti, and she didn't know who that was. At that time I started

challenging my insurance to get a referral to an Orthopedic Surgeon

at Cedar Sinai Hospital in Los Angeles, California. We were

successful and I have been very happy with this doctor, however he

indicated today at my sons check up, that he is going to recommend a

tendon transfer. My son is 18 months old, and has a tendancy to walk

on the outside of his foot, also, he still has cavus, which is the

reason for the surgical approach. I am wondering if the cavus is

still there because of the improper manipulations and casting in the

early days, and whether that can be corrected with the DBB over

time. He has been wearing the DBB at night and naps. He is able to

pull his foot out though which is a problem. My question to any of

you, should I reject the surgery? I do not want to do anything

drastic that will harm him, but I am afraid that further bracing

won't fix these problems and he won't walk correctly when he is

older. I would appreciate any advise that I can get or further

information on this subject.

Thank you.

[Guest guest]

That's quite a trip. I was thinking of doing the same thing if I can't get

the help that we need here in California. Another question for you: what is

the shoe? I have not heard of that until reading the message board.

We have not had good luck with the DBB, as my son, starting approximately 3

months ago, has been able to pull his foot out of the shoe when he sleeps. I

believe that this has something to do with the fact that he has the

" relapse " problems that he currently has. It's only the one foot, maybe

because it is a bit smaller than the other one. Is your son's affected foot

smaller than the other also? Have you heard any info on whether it will

eventually catch up?

Thank you for your support and input.

_____

From: kitaki

Sent: Saturday, March 20, 2004 6:33 PM

To: nosurgery4clubfoot

Subject: Re: tendon transfer?

Oh, if only I were! lol No, last September I flew from Seattle to Iowa

after it was determined that our doctor in Seattle (Dr Mosca) did not know

what he was dealing with in this unusual foot. I stayed in Iowa City 8

days. Since that time, Dr. Mosca has kept in very close touch with Dr

Ponseti about feet like Kai's as he currently has 4-5 patients with this

unusual cavus. In fact, another member here - kitegirl () has a

daughter with the same thing, and thanks to the information flow between Dr.

Mosca and Dr. Ponseti since I traveled there, she was able to avoid the trip

to Iowa.

Dr Mosca has been doing this last set of casting for us - we do day trips

from where we live in central WA to Seattle every 2 weeks - but Dr. Ponseti

is doing his best to gather as much info as he can about the condition, so

we keep in close touch with him via e-mail.

If you would like, you can e-mail me off board at m_kitaki@... .

Angel

tendon transfer?

Hi, I am new to this web site. My son was born with club

foot of his right foot. The pediatrician referred us to a

Podiatrist. After a couple of visits, and further research into the

Ponseti method of casting, I noticed that instead of gentle

manipulations, she was forcing the foot into a postion and allowing

the plaster cast to dry. I questioned whether she was familiar with

Ponseti, and she didn't know who that was. At that time I started

challenging my insurance to get a referral to an Orthopedic Surgeon

at Cedar Sinai Hospital in Los Angeles, California. We were

successful and I have been very happy with this doctor, however he

indicated today at my sons check up, that he is going to recommend a

tendon transfer. My son is 18 months old, and has a tendancy to walk

on the outside of his foot, also, he still has cavus, which is the

reason for the surgical approach. I am wondering if the cavus is

still there because of the improper manipulations and casting in the

early days, and whether that can be corrected with the DBB over

time. He has been wearing the DBB at night and naps. He is able to

pull his foot out though which is a problem. My question to any of

you, should I reject the surgery? I do not want to do anything

drastic that will harm him, but I am afraid that further bracing

won't fix these problems and he won't walk correctly when he is

older. I would appreciate any advise that I can get or further

information on this subject.

Thank you.

[Guest guest]

I am sorry I did not answer sooner ... my oldest figure skates on Sundays.

Anyway, the shoe is a shoe designed for feet that either have unusual

and frequently recurring cavus, or that just won't stay in the Markell shoe.

Dr. Ponseti had a shoemake in Iowa City design a shoe and bar based on the needs

of three children he saw within a few weeks of eachother for whom the Markell

shoes were not working - either not holding correction or not staying on the

feet. My son was the first of the 3, and I guess ended up being the " control "

for the test on the shoes, because he was the only one who did not get a pair.

Anyway, from my understanding (I have never seen them) the shoes are more like a

sandal and they have 3 straps and no laces. If you read the message that I sent

a couple days ago titled " An e-mail from Dr. P " you will see what Dr. Ponseti

has to say about the shoes and their effects on a cavus foot. Thay are still

mounted on a DBB style bar.

The shoes themselves are basically made custom and they are not widely

available. As far as I know, will only send them to people with

Dr. Ponseti's ok ... kind of by prescription from Dr P, I guess you would say.

BUT, you dont have to see Dr. P for him to have send them to you. He just

needs to know that they are appropriate for your childs troubles.

It is 100% normal for a unilateral cf to be shorter than the other. The " norm "

is approx 1/4 inch or less. A foot with residual or relapsed cavus is usually

quite significantly shorter than the non-cf. My son's foot before casting for

the cavus was close to 1/2 inch shorter than the other, which seems to be fairly

normal for his condition. With casting it comes back out to the more " normal "

length of withing 1/4 inch. To my knowledge they never catch up, but it is

nothing to be concerned about, either. Many people who have never even heard of

clubfoot have one foot shorter than the other. Also, in unilateral cases, it is

normal for the calf of the effected leg to be skinnier than the other because

clubfoot actually effects the muscles, ligaments and tendons of the whole leg.

Again it is not of any significance.

Angel

RE: tendon transfer?

That's quite a trip. I was thinking of doing the same thing if I can't get

the help that we need here in California. Another question for you: what is

the shoe? I have not heard of that until reading the message board.

We have not had good luck with the DBB, as my son, starting approximately 3

months ago, has been able to pull his foot out of the shoe when he sleeps. I

believe that this has something to do with the fact that he has the

" relapse " problems that he currently has. It's only the one foot, maybe

because it is a bit smaller than the other one. Is your son's affected foot

smaller than the other also? Have you heard any info on whether it will

eventually catch up?

Thank you for your support and input.