Guest guest Posted March 19, 2004 Report Share Posted March 19, 2004 I just wanted to share this e-mai l I received from Dr Ponseti tonight. It was in response to some information and questions I had sent him this week about Kai's recent trouble with the DBB and relapse, the possible need for surgery and the shoes. I am very relieved to learn that the shoes can actually help correct cavus, unlike the traditional DBB type bracing that only holds correction (or doesn't, in the case of plantaris cavus). Anyway, here is it ... hope it is some helpful info for the rest of you dealing with the confounding condition :-) Angel " March 19, 2004 It is very distressing to me that the good correction Kai got from the plaster casts was lost. These atypical clubfeet do not fit into the Markell shoes and 's shoes and brace are the only way we have found to maintain and indeed improve the correction obtained in the plaster casts. is in my office now and he is sure by the end of next week he will have the bigger shoes available. Apparently Kai's type of foot has loose ligaments in the front but is very stiff in the back and the deep plantar fascia. Therefore it is easy to correct the forefoot deformity but since the ligaments are weak, one tends to overcorrect it and the plantar ligament causes a severe increase in the cavus. I saw a case like this when I was in California last week. The same thing happened. The forefoot was overcorrected and in severe cavus while the hindfoot was in equinus in spite of an early tendo Achilles tenotomy. I talked with a doctor who had operated on one of these feet, loosening all of the joints in the middle of the foot, but scarring developed in the severed ligament and retracted and the deformity relapsed. Now that we understand the deformity better, proper manipulation and casting followed by use of 's shoes will solve this problem. As soon as you receive the new shoes you may want to remove the cast and apply the shoes. The new shoes and brace tend to improve the cavus and the alignment of the foot. Your concern about the leg being shorter is valid, but I hope there has been no damage to the growth plate in the tibia. Once the casting is discontinued, the leg may well regain normal length. I.V. Ponseti, M.D. (Joyce Roller, secretary) " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 20, 2004 Report Share Posted March 20, 2004 Hi Angel, Thank you for sharing the email from Dr. Ponseti. In testomoniny to what he wrote, Sadie's feet have improved in mithell shoes. She is in them 20-23 hours a day. I am hope Kia will have the same great success. see you soon, > I just wanted to share this e-mai l I received from Dr Ponseti tonight. It was in response to some information and questions I had sent him this week about Kai's recent trouble with the DBB and relapse, the possible need for surgery and the shoes. I am very relieved to learn that the shoes can actually help correct cavus, unlike the traditional DBB type bracing that only holds correction (or doesn't, in the case of plantaris cavus). Anyway, here is it ... hope it is some helpful info for the rest of you dealing with the confounding condition :-) Angel > > " March 19, 2004 > > It is very distressing to me that the good correction Kai got from the plaster casts was lost. These atypical clubfeet do not fit into the Markell shoes and 's shoes and brace are the only way we have found to maintain and indeed improve the correction obtained in the plaster casts. is in my office now and he is sure by the end of next week he will have the bigger shoes available. > > Apparently Kai's type of foot has loose ligaments in the front but is very stiff in the back and the deep plantar fascia. Therefore it is easy to correct the forefoot deformity but since the ligaments are weak, one tends to overcorrect it and the plantar ligament causes a severe increase in the cavus. I saw a case like this when I was in California last week. The same thing happened. The forefoot was overcorrected and in severe cavus while the hindfoot was in equinus in spite of an early tendo Achilles tenotomy. > > I talked with a doctor who had operated on one of these feet, loosening all of the joints in the middle of the foot, but scarring developed in the severed ligament and retracted and the deformity relapsed. Now that we understand the deformity better, proper manipulation and casting followed by use of 's shoes will solve this problem. As soon as you receive the new shoes you may want to remove the cast and apply the shoes. The new shoes and brace tend to improve the cavus and the alignment of the foot. Your concern about the leg being shorter is valid, but I hope there has been no damage to the growth plate in the tibia. Once the casting is discontinued, the leg may well regain normal length. > > I.V. Ponseti, M.D. > (Joyce Roller, secretary) " > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 21, 2004 Report Share Posted March 21, 2004 hello Angle, thanks for the email. i hope we wont need it but it is in my " archive " . thanks idit mom to Oshri, 7 month BL clbfeet 18h a day with DDB. > > I just wanted to share this e-mai l I received from Dr Ponseti > tonight. It was in response to some information and questions I had > sent him this week about Kai's recent trouble with the DBB and > relapse, the possible need for surgery and the shoes. I am > very relieved to learn that the shoes can actually help > correct cavus, unlike the traditional DBB type bracing that only > holds correction (or doesn't, in the case of plantaris cavus). > Anyway, here is it ... hope it is some helpful info for the rest of > you dealing with the confounding condition :-) Angel > > > > " March 19, 2004 > > > > It is very distressing to me that the good correction Kai got from > the plaster casts was lost. These atypical clubfeet do not fit into > the Markell shoes and 's shoes and brace are the only way we have > found to maintain and indeed improve the correction obtained in the > plaster casts. is in my office now and he is sure by the end of > next week he will have the bigger shoes available. > > > > Apparently Kai's type of foot has loose ligaments in the front but > is very stiff in the back and the deep plantar fascia. Therefore it > is easy to correct the forefoot deformity but since the ligaments are > weak, one tends to overcorrect it and the plantar ligament causes a > severe increase in the cavus. I saw a case like this when I was in > California last week. The same thing happened. The forefoot was > overcorrected and in severe cavus while the hindfoot was in equinus > in spite of an early tendo Achilles tenotomy. > > > > I talked with a doctor who had operated on one of these feet, > loosening all of the joints in the middle of the foot, but scarring > developed in the severed ligament and retracted and the deformity > relapsed. Now that we understand the deformity better, proper > manipulation and casting followed by use of 's shoes will solve > this problem. As soon as you receive the new shoes you may want to > remove the cast and apply the shoes. The new shoes and brace tend to > improve the cavus and the alignment of the foot. Your concern about > the leg being shorter is valid, but I hope there has been no damage > to the growth plate in the tibia. Once the casting is discontinued, > the leg may well regain normal length. > > > > I.V. Ponseti, M.D. > > (Joyce Roller, secretary) " > > > > Quote Link to comment Share on other sites More sharing options...
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