Re: Bilateral Clubfeet in San , Texas

[Guest guest]

,

Welcome to our group. We will try to provide you with some

information relating to the Ponseti method in Texas. Unfortunately,

there is not currently a doctor in Texas that is on Dr. Ponseti's

list of those qualified in his method. It is possible that Dr.

Ponseti is aware of someone who is using the method well there. I

would encourage you to e-mail or contact Dr. Ponseti at (319)356-

3469 or ignacio-ponseti @ uiowa.edu

Dr. Ponseti's web site is at

http://www.vh.org/pediatric/patient/orthopaedics/clubfeet/index.html

For a while, there was a Dr. Godfried at Texas Tech in Lubbock

who had learned the Ponseti method at Northwestern Children's

Memorial in Chicago before moving to Lubbock. He published a study

on the first Ponseti method children he treated at the 2002 POSNA

Convention that stated that he was successful about 95% of the time

in the non-surgical application of the Ponseti method between August

1999 and August 2001. But I believe that he has since moved away

from Texas. An abstract of his report is as follows:

EARLY EXPERIENCE WITH PONSETI METHOD OF CLUBFOOT

TREATMENT IN CONSECUTIVE COHORT OF INFANTS.

H. Godfried, MD (Texas Tech University Medical School, Lubbock,

Texas 79430, USA)

INTRODUCTION: The optimal method of treatment for resistant clubfoot

deformity in infants is a recurring topic of debate among pediatric

orthopaedists. A handful of centers have published data suggesting

that over 80% of moderate to severe clubfoot deformities can be

managed successfully during the first year of life without extensive

surgery. The purpose of this study is to report problems, obstacles

and complications encountered with the Ponseti Technique and to

assess clinical results one year after initiation of treatment.

METHODS: The Ponseti Technique was the only method of treatment

offered families between August of 1999 and August of 2001. A cohort

of 28 consecutive children (42 feet) with resistant clubfoot

deformity were treated (single institution, single surgeon). One

family chose to go elsewhere after initial evaluation and description

of treatment protocol. Digital photographs and DiMeglio severity

scores were obtained prior to initial casting. Etiology: 82% -

idiopathic, 14% - arthrogryposis, 4% - myelomeningocele. Gender: 64%

male. Side: 50% bilateral. Family history clubfoot: 40%. Prior

casting in 11% infants. Average age at initiation of casting = 25

days (3-210). Average initial DiMeglio severity score = 11.8 (5-16).

Average duration of casting = 5.5 weeks (3-11). Average number of

long leg casts = 4.5 (2-7). Percentage of feet undergoing

percutaneous tenotomy = 95%. Clinic sedation: local anesthetic and

chloral hydrate. No prophylactic antibiotics.

RESULTS: Casting protocol was completed with all children. Site

tenotomy performed: clinic - 32 feet, operating room - 8 feet. Wound

infection - 0%. Hospital admissions - 0%. Bracing protocol completed:

without modification - 70%, with modification - 20%, not tolerated -

10%. Secondary procedures: recasting - 10%, repeat tenotomy - 5%,

formal surgical release - 5%. Average DiMeglio score one year after

initiation treatment 1.8 (0-5). Pre-treatment severity and diagnosis

of arthrogryposis not predictive of outcome or obstacles encountered.

CONCLUSIONS: The Ponseti Technique can be safely applied in the

treatment of clubfoot deformity in infants. 95% of cohort was managed

during the first year without extensive surgical release. Long-term

follow-up data is being collected for this cohort and is necessary to

document functional outcomes as well as recurrence rates and

additional surgical procedures.

http://health.groups.yahoo.com/group/nosurgery4clubfoot/message/14343

During the past 6-7 years, Dallas ish Rite Hospital has been

emphasising a treatment method known as French Physiotherapy. The

French methods done at Dallas have shown about a 60% rate of success

in avoiding the Posterior release types of surgery.

In the past couple of years, Dallas has also begun doing a Ponseti

like method but their non-surgical results with their version of the

Ponseti method are not as good as what has been reported at the

University of Iowa and elsewhere. There was also a group in San

who was using the French Physiotherapy methods 2-3 years ago

but we are not sure what they are doing now.

We had also hoped that Texas Childrens Medical Center and Shriners

in Houston would be starting to use the Ponseti method, but so far,

we have not heard from any parents in Texas who have expressed that

their doctors are committed to the Ponseti method.

It seems that there have been some parents in Austin who had

mentioned that their doctor was using the Ponseti method. You could

try calling the Ped Ortho's in San to ask them but be

careful as we have had many parents where doctors told them they

were using the Ponseti method and the doctors had modified the

method somewhat so that it didn't work quite as well.

Dr. Ponseti has told us that the honest answers to 2 questions can

help a parent have an idea if a doctor is using his method.

1. What percentage of children you treat need to have some form of

the posterior release types of surgery? The answer should be less

than 10% and hopefully about 5%.

2. How many Ponseti method casts does it typically take you to

correctly position a child's feet? The answer should be less than 7

casts and never more than 9.

Here are a list of 12 pediatric orthopedic doctors in 7 groups in

San who are members of the Pediatric Orthopedic Society of

North America (POSNA) There will also be other orthopedists and

podiatrists in your area that may treat clubfoot. Dr. Kaye Wilkins

was one of the doctors who was using French Physiotherapy 2-3 years

ago. They were getting training in the French method from

physiotherapits at Dallas ish Rite. Be careful in trying to

find out who is using the real Ponseti method (if anyone).

Dr. Kaye E. Wilkins

Dr. Edeen

Dr. Magnabosco

Dr. Earl A. Stanley

Dr. R. Warman

4499 Medical Drive

Suite 235

San , TX 78229

Telephone:(210)692-1613

Fax:(210)616-0290

Dr. B. Gledhill

8255 Fredericksburg Road

San , TX 78229

Telephone: (210)615-8292

Fax: (210)615-8297

Dr. M. Palmer

540 Madison Oak Dr, #500

San , TX 78258-3923

Dr. M.

Dr. Kent A. Reinker

University of Texas Health Sciences Center

Department of Orthopaedics

7300 Floyd Curl Drive

San , TX 78284-7774

Telephone:

Fax:

email address: reinkerk @ gte.net

Dr.

7614 Pastor Dr

Suite 300

San , TX 78229

Telephone:

Fax:

Dr. M. Stefko

859 MSGS/MCSO

2200 Bergquist Drive, Suite 1

San , TX 78236-5300

Telephone: (210)292-5843

Fax: (210)292-5844

Dr. Ira M. Yount

4499 Medical Dr, #120

San , TX 78229-3711

http://www.posna.org/index?service=page&context=memberDirectory

Please continue to ask any questions that you may have.

and (3-17-99)

http://www.vh.org/pediatric/patient/orthopaedics/clubfeet/egbert.html

> Good morning,

>

> I'm almost 6 months pregnant and our baby has been diagnosed with

> bilateral clubfeet. Since our diagnosis, about a month ago, I've

> been surfing the internet trying to educate myself about the

> abnormality.

>

> My husband and I have been very impressed with what we have read

> about the Ponseti Method and feel this is the way to go for our

baby.

>

> However, every search I've done for a doctor in San , Texas

> has come up empty handed. My next visit with my OBGYN is July 1st

> and I will ask her for a recommendation.

>

> I just wanted to know if anyone was from San or the

> surrounding areas (Austin, Houston or Dallas) & could point us in

> the right direction. As I'm sure all of you know - we don't just

> want a doctor that's heard of the Ponseti Method but one that's

> proficient in his methods.

>

> Any advice would be greatly appreciated.

>

> Sincerly,

> & Craig

[Guest guest]

,

I know it would be really nice to have a Dr close to home, but if you are like

most of the rest of us, you will need to fly or drive many hours to see a

Ponseti Dr. We live in Southeast Alaska and take our daughter down to Seattle

to see Dr. Mosca. If you can arrange it into your life, many people go to Iowa

to see Dr. Ponseti himself. They stay at the Mc house there for

about a month until the correction is done and then go home.

Whatever you decide, there are several Dr.'s in the US that practice the

nonsurgical method so hopefully you will be able to find one who is reasonably

close to you or to relatives you can stay with.

Congratulations and best of luck,

Robin & Rose

3/11/03

Right club foot

jenhundley jenhundley@...> wrote:

Good morning,

I'm almost 6 months pregnant and our baby has been diagnosed with

bilateral clubfeet. Since our diagnosis, about a month ago, I've

been surfing the internet trying to educate myself about the

abnormality.

My husband and I have been very impressed with what we have read

about the Ponseti Method and feel this is the way to go for our baby.

However, every search I've done for a doctor in San , Texas

has come up empty handed. My next visit with my OBGYN is July 1st

and I will ask her for a recommendation.

I just wanted to know if anyone was from San or the

surrounding areas (Austin, Houston or Dallas) & could point us in

the right direction. As I'm sure all of you know - we don't just

want a doctor that's heard of the Ponseti Method but one that's

proficient in his methods.

Any advice would be greatly appreciated.

Sincerly,

& Craig

[Guest guest]

Robin, thank you so much for getting back to me. I know I still have a ways to

go before I start any procedures (4 months) but I understand the sooner the

better, regarding treatment.

I hope your daughter is doing well. Do you have to travel their for the shoes

as well (Dennis Brown Bar)?

Thanks for the information regarding the Mc house. I do get 3

months maternity leave from work so it might be a possibility. Again thank you

and if you think of anything else or advice you'd like to give us please don't

hesitate.

Robin Lane robin_99833@...> wrote:

,

I know it would be really nice to have a Dr close to home, but if you are like

most of the rest of us, you will need to fly or drive many hours to see a

Ponseti Dr. We live in Southeast Alaska and take our daughter down to Seattle

to see Dr. Mosca. If you can arrange it into your life, many people go to Iowa

to see Dr. Ponseti himself. They stay at the Mc house there for

about a month until the correction is done and then go home.

Whatever you decide, there are several Dr.'s in the US that practice the

nonsurgical method so hopefully you will be able to find one who is reasonably

close to you or to relatives you can stay with.

Congratulations and best of luck,

Robin & Rose

3/11/03

Right club foot

jenhundley jenhundley@...> wrote:

Good morning,

I'm almost 6 months pregnant and our baby has been diagnosed with

bilateral clubfeet. Since our diagnosis, about a month ago, I've

been surfing the internet trying to educate myself about the

abnormality.

My husband and I have been very impressed with what we have read

about the Ponseti Method and feel this is the way to go for our baby.

However, every search I've done for a doctor in San , Texas

has come up empty handed. My next visit with my OBGYN is July 1st

and I will ask her for a recommendation.

I just wanted to know if anyone was from San or the

surrounding areas (Austin, Houston or Dallas) & could point us in

the right direction. As I'm sure all of you know - we don't just

want a doctor that's heard of the Ponseti Method but one that's

proficient in his methods.

Any advice would be greatly appreciated.

Sincerly,

& Craig

[Guest guest]

Thank you so much for getting back to me. I did email Dr Ponseti last Thursday

and am still waiting for a reply. I'm sure he's extremely busy as well as his

staff.

I'm surprised there isn't anyone here as San is a large city with a very

large Medical Center and well as a research center. I'd think Dr Ponseti's

Method would be familiar to many in the industry, I'm finding out otherwise.

Again, thank you and we'll keep plugging away.

Sincerely,

Egbert martinegbert@...> wrote:

,

Welcome to our group. We will try to provide you with some

information relating to the Ponseti method in Texas. Unfortunately,

there is not currently a doctor in Texas that is on Dr. Ponseti's

list of those qualified in his method. It is possible that Dr.

Ponseti is aware of someone who is using the method well there. I

would encourage you to e-mail or contact Dr. Ponseti at (319)356-

3469 or ignacio-ponseti @ uiowa.edu

Dr. Ponseti's web site is at

http://www.vh.org/pediatric/patient/orthopaedics/clubfeet/index.html

For a while, there was a Dr. Godfried at Texas Tech in Lubbock

who had learned the Ponseti method at Northwestern Children's

Memorial in Chicago before moving to Lubbock. He published a study

on the first Ponseti method children he treated at the 2002 POSNA

Convention that stated that he was successful about 95% of the time

in the non-surgical application of the Ponseti method between August

1999 and August 2001. But I believe that he has since moved away

from Texas. An abstract of his report is as follows:

EARLY EXPERIENCE WITH PONSETI METHOD OF CLUBFOOT

TREATMENT IN CONSECUTIVE COHORT OF INFANTS.

H. Godfried, MD (Texas Tech University Medical School, Lubbock,

Texas 79430, USA)

INTRODUCTION: The optimal method of treatment for resistant clubfoot

deformity in infants is a recurring topic of debate among pediatric

orthopaedists. A handful of centers have published data suggesting

that over 80% of moderate to severe clubfoot deformities can be

managed successfully during the first year of life without extensive

surgery. The purpose of this study is to report problems, obstacles

and complications encountered with the Ponseti Technique and to

assess clinical results one year after initiation of treatment.

METHODS: The Ponseti Technique was the only method of treatment

offered families between August of 1999 and August of 2001. A cohort

of 28 consecutive children (42 feet) with resistant clubfoot

deformity were treated (single institution, single surgeon). One

family chose to go elsewhere after initial evaluation and description

of treatment protocol. Digital photographs and DiMeglio severity

scores were obtained prior to initial casting. Etiology: 82% -

idiopathic, 14% - arthrogryposis, 4% - myelomeningocele. Gender: 64%

male. Side: 50% bilateral. Family history clubfoot: 40%. Prior

casting in 11% infants. Average age at initiation of casting = 25

days (3-210). Average initial DiMeglio severity score = 11.8 (5-16).

Average duration of casting = 5.5 weeks (3-11). Average number of

long leg casts = 4.5 (2-7). Percentage of feet undergoing

percutaneous tenotomy = 95%. Clinic sedation: local anesthetic and

chloral hydrate. No prophylactic antibiotics.

RESULTS: Casting protocol was completed with all children. Site

tenotomy performed: clinic - 32 feet, operating room - 8 feet. Wound

infection - 0%. Hospital admissions - 0%. Bracing protocol completed:

without modification - 70%, with modification - 20%, not tolerated -

10%. Secondary procedures: recasting - 10%, repeat tenotomy - 5%,

formal surgical release - 5%. Average DiMeglio score one year after

initiation treatment 1.8 (0-5). Pre-treatment severity and diagnosis

of arthrogryposis not predictive of outcome or obstacles encountered.

CONCLUSIONS: The Ponseti Technique can be safely applied in the

treatment of clubfoot deformity in infants. 95% of cohort was managed

during the first year without extensive surgical release. Long-term

follow-up data is being collected for this cohort and is necessary to

document functional outcomes as well as recurrence rates and

additional surgical procedures.

http://health.groups.yahoo.com/group/nosurgery4clubfoot/message/14343

During the past 6-7 years, Dallas ish Rite Hospital has been

emphasising a treatment method known as French Physiotherapy. The

French methods done at Dallas have shown about a 60% rate of success

in avoiding the Posterior release types of surgery.

In the past couple of years, Dallas has also begun doing a Ponseti

like method but their non-surgical results with their version of the

Ponseti method are not as good as what has been reported at the

University of Iowa and elsewhere. There was also a group in San

who was using the French Physiotherapy methods 2-3 years ago

but we are not sure what they are doing now.

We had also hoped that Texas Childrens Medical Center and Shriners

in Houston would be starting to use the Ponseti method, but so far,

we have not heard from any parents in Texas who have expressed that

their doctors are committed to the Ponseti method.

It seems that there have been some parents in Austin who had

mentioned that their doctor was using the Ponseti method. You could

try calling the Ped Ortho's in San to ask them but be

careful as we have had many parents where doctors told them they

were using the Ponseti method and the doctors had modified the

method somewhat so that it didn't work quite as well.

Dr. Ponseti has told us that the honest answers to 2 questions can

help a parent have an idea if a doctor is using his method.

1. What percentage of children you treat need to have some form of

the posterior release types of surgery? The answer should be less

than 10% and hopefully about 5%.

2. How many Ponseti method casts does it typically take you to

correctly position a child's feet? The answer should be less than 7

casts and never more than 9.

Here are a list of 12 pediatric orthopedic doctors in 7 groups in

San who are members of the Pediatric Orthopedic Society of

North America (POSNA) There will also be other orthopedists and

podiatrists in your area that may treat clubfoot. Dr. Kaye Wilkins

was one of the doctors who was using French Physiotherapy 2-3 years

ago. They were getting training in the French method from

physiotherapits at Dallas ish Rite. Be careful in trying to

find out who is using the real Ponseti method (if anyone).

Dr. Kaye E. Wilkins

Dr. Edeen

Dr. Magnabosco

Dr. Earl A. Stanley

Dr. R. Warman

4499 Medical Drive

Suite 235

San , TX 78229

Telephone:(210)692-1613

Fax:(210)616-0290

Dr. B. Gledhill

8255 Fredericksburg Road

San , TX 78229

Telephone: (210)615-8292

Fax: (210)615-8297

Dr. M. Palmer

540 Madison Oak Dr, #500

San , TX 78258-3923

Dr. M.

Dr. Kent A. Reinker

University of Texas Health Sciences Center

Department of Orthopaedics

7300 Floyd Curl Drive

San , TX 78284-7774

Telephone:

Fax:

email address: reinkerk @ gte.net

Dr.

7614 Pastor Dr

Suite 300

San , TX 78229

Telephone:

Fax:

Dr. M. Stefko

859 MSGS/MCSO

2200 Bergquist Drive, Suite 1

San , TX 78236-5300

Telephone: (210)292-5843

Fax: (210)292-5844

Dr. Ira M. Yount

4499 Medical Dr, #120

San , TX 78229-3711

http://www.posna.org/index?service=page&context=memberDirectory

Please continue to ask any questions that you may have.

and (3-17-99)

http://www.vh.org/pediatric/patient/orthopaedics/clubfeet/egbert.html

> Good morning,

>

> I'm almost 6 months pregnant and our baby has been diagnosed with

> bilateral clubfeet. Since our diagnosis, about a month ago, I've

> been surfing the internet trying to educate myself about the

> abnormality.

>

> My husband and I have been very impressed with what we have read

> about the Ponseti Method and feel this is the way to go for our

baby.

>

> However, every search I've done for a doctor in San , Texas

> has come up empty handed. My next visit with my OBGYN is July 1st

> and I will ask her for a recommendation.

>

> I just wanted to know if anyone was from San or the

> surrounding areas (Austin, Houston or Dallas) & could point us in

> the right direction. As I'm sure all of you know - we don't just

> want a doctor that's heard of the Ponseti Method but one that's

> proficient in his methods.

>

> Any advice would be greatly appreciated.

>

> Sincerly,

> & Craig

[Guest guest]

,

We have been lucky in that the ortho department at Childrens Hospital in Seattle

will mail us the shoes when we need new ones. There is an ortho in Ketchikan

which Rose sees every three months just to make sure her foot looks good. We

are lucky because he comes to Wrangell which is on the next Island over from us

and we have an office there. This is nice because I have a place to stay and a

car to drive. He sends all of his observations to Dr. Mosca in Seattle and they

confir when necessary.

Just a note, I spent my 3 months maternity leave going back and forth to

Ketchikan getting Rose's casts changed and then on to Seattle. Luckily but the

time she was ready for the DBB, I was going back to work and my daycare was

wonderful! The lady who watched Rose when she was little had a sister who wore

the DBB 40 years ago so at least she was not afraid of it. We have had no

problems and all has gone well. Rose didn't sleep through the night until she

started walking, but I think that was just her. I didn't ever do the " cry it

out " thing, I would just go get her when she cried. I figured that the poor

little thing already had her feet tied together at night and that was enough to

deal with.

In case you are wondering, we had no problems with rolling over or crawling or

walking. If anything, the DBB gave my baby rock hard abs and she was using the

casts and/or DBB for leverage to turn over. We had about 2 days of misery when

we first put the DBB on her. She didn't like it and cried alot. But, once she

got used to it and realized she could still kick, she was fine.

I don't really know how the Mc house works, but some of the other

mothers could help you there. Angel took Kai to Iowa and stayed there so I am

sure she could help you out. There are also ways to get free airfare, although

we never used any of that stuff.

Best of luck and email me anytime.

Robin & Rose

Hundley jenhundley@...> wrote:

Robin, thank you so much for getting back to me. I know I still have a ways to

go before I start any procedures (4 months) but I understand the sooner the

better, regarding treatment.

I hope your daughter is doing well. Do you have to travel their for the shoes

as well (Dennis Brown Bar)?

Thanks for the information regarding the Mc house. I do get 3

months maternity leave from work so it might be a possibility. Again thank you

and if you think of anything else or advice you'd like to give us please don't

hesitate.

Robin Lane robin_99833@...> wrote:

,

I know it would be really nice to have a Dr close to home, but if you are like

most of the rest of us, you will need to fly or drive many hours to see a

Ponseti Dr. We live in Southeast Alaska and take our daughter down to Seattle

to see Dr. Mosca. If you can arrange it into your life, many people go to Iowa

to see Dr. Ponseti himself. They stay at the Mc house there for

about a month until the correction is done and then go home.

Whatever you decide, there are several Dr.'s in the US that practice the

nonsurgical method so hopefully you will be able to find one who is reasonably

close to you or to relatives you can stay with.

Congratulations and best of luck,

Robin & Rose

3/11/03

Right club foot

jenhundley jenhundley@...> wrote:

Good morning,

I'm almost 6 months pregnant and our baby has been diagnosed with

bilateral clubfeet. Since our diagnosis, about a month ago, I've

been surfing the internet trying to educate myself about the

abnormality.

My husband and I have been very impressed with what we have read

about the Ponseti Method and feel this is the way to go for our baby.

However, every search I've done for a doctor in San , Texas

has come up empty handed. My next visit with my OBGYN is July 1st

and I will ask her for a recommendation.

I just wanted to know if anyone was from San or the

surrounding areas (Austin, Houston or Dallas) & could point us in

the right direction. As I'm sure all of you know - we don't just

want a doctor that's heard of the Ponseti Method but one that's

proficient in his methods.

Any advice would be greatly appreciated.

Sincerly,

& Craig

[Guest guest]

, I had mentioned in my last email that I had emailed Dr Ponseti looking

for a doctor in Texas last Thursday (6/24//4). Do you know, roughly, about how

long it takes to receive a response? I'm sure he & his staff are extremely

busy, just wondering how long I should wait before I email him again.

Thanks again for all your information. I'm so thankful that I found this

website as reading everyones emails has given me great comfort. I don't

understand half of them at this point but it's good to know what I'll be up

against when Aiden is born in October.

Sincerely,

Egbert martinegbert@...> wrote:

,

Welcome to our group. We will try to provide you with some

information relating to the Ponseti method in Texas. Unfortunately,

there is not currently a doctor in Texas that is on Dr. Ponseti's

list of those qualified in his method. It is possible that Dr.

Ponseti is aware of someone who is using the method well there. I

would encourage you to e-mail or contact Dr. Ponseti at (319)356-

3469 or ignacio-ponseti @ uiowa.edu

Dr. Ponseti's web site is at

http://www.vh.org/pediatric/patient/orthopaedics/clubfeet/index.html

For a while, there was a Dr. Godfried at Texas Tech in Lubbock

who had learned the Ponseti method at Northwestern Children's

Memorial in Chicago before moving to Lubbock. He published a study

on the first Ponseti method children he treated at the 2002 POSNA

Convention that stated that he was successful about 95% of the time

in the non-surgical application of the Ponseti method between August

1999 and August 2001. But I believe that he has since moved away

from Texas. An abstract of his report is as follows:

EARLY EXPERIENCE WITH PONSETI METHOD OF CLUBFOOT

TREATMENT IN CONSECUTIVE COHORT OF INFANTS.

H. Godfried, MD (Texas Tech University Medical School, Lubbock,

Texas 79430, USA)

INTRODUCTION: The optimal method of treatment for resistant clubfoot

deformity in infants is a recurring topic of debate among pediatric

orthopaedists. A handful of centers have published data suggesting

that over 80% of moderate to severe clubfoot deformities can be

managed successfully during the first year of life without extensive

surgery. The purpose of this study is to report problems, obstacles

and complications encountered with the Ponseti Technique and to

assess clinical results one year after initiation of treatment.

METHODS: The Ponseti Technique was the only method of treatment

offered families between August of 1999 and August of 2001. A cohort

of 28 consecutive children (42 feet) with resistant clubfoot

deformity were treated (single institution, single surgeon). One

family chose to go elsewhere after initial evaluation and description

of treatment protocol. Digital photographs and DiMeglio severity

scores were obtained prior to initial casting. Etiology: 82% -

idiopathic, 14% - arthrogryposis, 4% - myelomeningocele. Gender: 64%

male. Side: 50% bilateral. Family history clubfoot: 40%. Prior

casting in 11% infants. Average age at initiation of casting = 25

days (3-210). Average initial DiMeglio severity score = 11.8 (5-16).

Average duration of casting = 5.5 weeks (3-11). Average number of

long leg casts = 4.5 (2-7). Percentage of feet undergoing

percutaneous tenotomy = 95%. Clinic sedation: local anesthetic and

chloral hydrate. No prophylactic antibiotics.

RESULTS: Casting protocol was completed with all children. Site

tenotomy performed: clinic - 32 feet, operating room - 8 feet. Wound

infection - 0%. Hospital admissions - 0%. Bracing protocol completed:

without modification - 70%, with modification - 20%, not tolerated -

10%. Secondary procedures: recasting - 10%, repeat tenotomy - 5%,

formal surgical release - 5%. Average DiMeglio score one year after

initiation treatment 1.8 (0-5). Pre-treatment severity and diagnosis

of arthrogryposis not predictive of outcome or obstacles encountered.

CONCLUSIONS: The Ponseti Technique can be safely applied in the

treatment of clubfoot deformity in infants. 95% of cohort was managed

during the first year without extensive surgical release. Long-term

follow-up data is being collected for this cohort and is necessary to

document functional outcomes as well as recurrence rates and

additional surgical procedures.

http://health.groups.yahoo.com/group/nosurgery4clubfoot/message/14343

During the past 6-7 years, Dallas ish Rite Hospital has been

emphasising a treatment method known as French Physiotherapy. The

French methods done at Dallas have shown about a 60% rate of success

in avoiding the Posterior release types of surgery.

In the past couple of years, Dallas has also begun doing a Ponseti

like method but their non-surgical results with their version of the

Ponseti method are not as good as what has been reported at the

University of Iowa and elsewhere. There was also a group in San

who was using the French Physiotherapy methods 2-3 years ago

but we are not sure what they are doing now.

We had also hoped that Texas Childrens Medical Center and Shriners

in Houston would be starting to use the Ponseti method, but so far,

we have not heard from any parents in Texas who have expressed that

their doctors are committed to the Ponseti method.

It seems that there have been some parents in Austin who had

mentioned that their doctor was using the Ponseti method. You could

try calling the Ped Ortho's in San to ask them but be

careful as we have had many parents where doctors told them they

were using the Ponseti method and the doctors had modified the

method somewhat so that it didn't work quite as well.

Dr. Ponseti has told us that the honest answers to 2 questions can

help a parent have an idea if a doctor is using his method.

1. What percentage of children you treat need to have some form of

the posterior release types of surgery? The answer should be less

than 10% and hopefully about 5%.

2. How many Ponseti method casts does it typically take you to

correctly position a child's feet? The answer should be less than 7

casts and never more than 9.

Here are a list of 12 pediatric orthopedic doctors in 7 groups in

San who are members of the Pediatric Orthopedic Society of

North America (POSNA) There will also be other orthopedists and

podiatrists in your area that may treat clubfoot. Dr. Kaye Wilkins

was one of the doctors who was using French Physiotherapy 2-3 years

ago. They were getting training in the French method from

physiotherapits at Dallas ish Rite. Be careful in trying to

find out who is using the real Ponseti method (if anyone).

Dr. Kaye E. Wilkins

Dr. Edeen

Dr. Magnabosco

Dr. Earl A. Stanley

Dr. R. Warman

4499 Medical Drive

Suite 235

San , TX 78229

Telephone:(210)692-1613

Fax:(210)616-0290

Dr. B. Gledhill

8255 Fredericksburg Road

San , TX 78229

Telephone: (210)615-8292

Fax: (210)615-8297

Dr. M. Palmer

540 Madison Oak Dr, #500

San , TX 78258-3923

Dr. M.

Dr. Kent A. Reinker

University of Texas Health Sciences Center

Department of Orthopaedics

7300 Floyd Curl Drive

San , TX 78284-7774

Telephone:

Fax:

email address: reinkerk @ gte.net

Dr.

7614 Pastor Dr

Suite 300

San , TX 78229

Telephone:

Fax:

Dr. M. Stefko

859 MSGS/MCSO

2200 Bergquist Drive, Suite 1

San , TX 78236-5300

Telephone: (210)292-5843

Fax: (210)292-5844

Dr. Ira M. Yount

4499 Medical Dr, #120

San , TX 78229-3711

http://www.posna.org/index?service=page&context=memberDirectory

Please continue to ask any questions that you may have.

and (3-17-99)

http://www.vh.org/pediatric/patient/orthopaedics/clubfeet/egbert.html

> Good morning,

>

> I'm almost 6 months pregnant and our baby has been diagnosed with

> bilateral clubfeet. Since our diagnosis, about a month ago, I've

> been surfing the internet trying to educate myself about the

> abnormality.

>

> My husband and I have been very impressed with what we have read

> about the Ponseti Method and feel this is the way to go for our

baby.

>

> However, every search I've done for a doctor in San , Texas

> has come up empty handed. My next visit with my OBGYN is July 1st

> and I will ask her for a recommendation.

>

> I just wanted to know if anyone was from San or the

> surrounding areas (Austin, Houston or Dallas) & could point us in

> the right direction. As I'm sure all of you know - we don't just

> want a doctor that's heard of the Ponseti Method but one that's

> proficient in his methods.

>

> Any advice would be greatly appreciated.

>

> Sincerly,

> & Craig

[Guest guest]

,

If Dr. Ponseti is in town, he responds right away. Occasionally he

is at meetings or otherwise out of town for short periods. You

could also try calling him by phone. If he is not there, he will

return your call.

> > Good morning,

> >

> > I'm almost 6 months pregnant and our baby has been diagnosed

with

> > bilateral clubfeet. Since our diagnosis, about a month ago,

I've

> > been surfing the internet trying to educate myself about the

> > abnormality.

> >

> > My husband and I have been very impressed with what we have read

> > about the Ponseti Method and feel this is the way to go for our

> baby.

> >

> > However, every search I've done for a doctor in San ,

Texas

> > has come up empty handed. My next visit with my OBGYN is July

1st

> > and I will ask her for a recommendation.

> >

> > I just wanted to know if anyone was from San or the

> > surrounding areas (Austin, Houston or Dallas) & could point us

in

> > the right direction. As I'm sure all of you know - we don't

just

> > want a doctor that's heard of the Ponseti Method but one that's

> > proficient in his methods.

> >

> > Any advice would be greatly appreciated.

> >

> > Sincerly,

> > & Craig

>

>

>

>

[Guest guest]

Thanks , I will try leaving a message. I'm sure I'm jumping the gun a

little as I'm not due till the end of October, but am eager to get hooked up

with a " Qualified " Ponseti Dr. Can't start those interviews to early! :-)

Seriously, I just want to do it right the first time. I've been surfing the

Internet and reading peoples stories for about a month and I've read too many

cases where the Ponseti Method wasn't used and kids have been in casts for years

or have had multiple surgeries, I'd like to avoid that if possible.

Thanks for getting back to me.

& Craig

Egbert martinegbert@...> wrote:

,

If Dr. Ponseti is in town, he responds right away. Occasionally he

is at meetings or otherwise out of town for short periods. You

could also try calling him by phone. If he is not there, he will

return your call.

> > Good morning,

> >

> > I'm almost 6 months pregnant and our baby has been diagnosed

with

> > bilateral clubfeet. Since our diagnosis, about a month ago,

I've

> > been surfing the internet trying to educate myself about the

> > abnormality.

> >

> > My husband and I have been very impressed with what we have read

> > about the Ponseti Method and feel this is the way to go for our

> baby.

> >

> > However, every search I've done for a doctor in San ,

Texas

> > has come up empty handed. My next visit with my OBGYN is July

1st

> > and I will ask her for a recommendation.

> >

> > I just wanted to know if anyone was from San or the

> > surrounding areas (Austin, Houston or Dallas) & could point us

in

> > the right direction. As I'm sure all of you know - we don't

just

> > want a doctor that's heard of the Ponseti Method but one that's

> > proficient in his methods.

> >

> > Any advice would be greatly appreciated.

> >

> > Sincerly,

> > & Craig

>

>

>

>