Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 I received the August issue of American Baby today and there's an article under the 'About Baby's Health' section it's about baby feet. On page 28 there's almost a whole column devoted to club feet and they describe the Ponseti method without naming it. However, the do make the statement " your baby should quickly catch up on achieving motor skills such as rolling or crawling once the casts are removed " . Man I'd sure like for the author to see booking it across the floor with her brace! Chris Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 No kidding! Don't these writers research a thing???? s. Man I'd sure like for the author to see booking it across the floor with her brace! Chris Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2004 Report Share Posted July 28, 2004 uhhh... what kinds of things is a baby supposed to be doing motor skills wise at 5-9w? If baby is corrected in 3-7 casts at birth or shortly thereafter (which the majority of Ponseti babies are) then what's the problem with motor skills and casts? Theoretically, I know some babies are casted later but when they report these things they'll usually say something like *baby is casted in the first few weeks after birth for blah, blah, blah weeks... " so I'm aiming this at this article. Nice. What galls me is that they ignored the data for so many years. Now that's stupid if you ask me. Why is this so unknown if it works this well? Duh! Is this so *out there* that the whole orthopaedic medical community ignored it for 40 years and then decides perhaps it does work so we'll reluctantly try it? I would love to hear a good explanation for this not being given due consideration for so long. Dr. Ponseti deserves to be recognized a long time ago IMO. Kori At 05:17 PM 7/27/2004, you wrote: >I received the August issue of American Baby today and there's an article >under the 'About Baby's Health' section it's about baby feet. On page 28 >there's almost a whole column devoted to club feet and they describe the >Ponseti method without naming it. However, the do make the statement > " your baby should quickly catch up on achieving motor skills such as >rolling or crawling once the casts are removed " . Man I'd sure like for >the author to see booking it across the floor with her brace! > >Chris > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2004 Report Share Posted July 28, 2004 I think the Ponseti Method was the world's best kept secret for all those years until this list started. I was SO fortunate, see, the list started only a few months prior to my finding it - and I don't even remember how I did find it. I think it was a God-Thing. Maybe it's just that club feet are not " exciting " enough in the medical field compared to say inutero heart transplants that the doctors don't pay much attention to finding a new, better, easier way to fix the feet. Operating is much more exciting and a boost to the ego than a few casts and a little brace. How dull is that??? Where's the drama, kwim? I think most doctors are in love with the drama that the Ponseti Method so happily lacks in. I was lead to beleive from the start my son would need his feet operated on perhaps many times. I learned different of course, but with my 2nd son, once again the doctors told me he'd need operations and would not listen to me say there IS a better way. My fear is that Dr. Ponseti is not a young man and when he dies, will his method really continue in it's purest form with so few " Qualified " doctors here to carry it on unmollested? s. Re: American Baby Article uhhh... what kinds of things is a baby supposed to be doing motor skills wise at 5-9w? If baby is corrected in 3-7 casts at birth or shortly thereafter (which the majority of Ponseti babies are) then what's the problem with motor skills and casts? Theoretically, I know some babies are casted later but when they report these things they'll usually say something like *baby is casted in the first few weeks after birth for blah, blah, blah weeks... " so I'm aiming this at this article. Nice. What galls me is that they ignored the data for so many years. Now that's stupid if you ask me. Why is this so unknown if it works this well? Duh! Is this so *out there* that the whole orthopaedic medical community ignored it for 40 years and then decides perhaps it does work so we'll reluctantly try it? I would love to hear a good explanation for this not being given due consideration for so long. Dr. Ponseti deserves to be recognized a long time ago IMO. Kori At 05:17 PM 7/27/2004, you wrote: >I received the August issue of American Baby today and there's an article >under the 'About Baby's Health' section it's about baby feet. On page 28 >there's almost a whole column devoted to club feet and they describe the >Ponseti method without naming it. However, the do make the statement > " your baby should quickly catch up on achieving motor skills such as >rolling or crawling once the casts are removed " . Man I'd sure like for >the author to see booking it across the floor with her brace! > >Chris > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2004 Report Share Posted July 28, 2004 We often have discussions about " why " the Ponseti method took so darn long to become mainstream. Additionally, we have discussions about why doctors won't follow the method as it was developed, but continue to tweak it. Most of us (I freely admit to being in this group) parents who are not in the medical industry, have our cynical views of why surgeons reject/tweak the method mostly revolving around ego &/or money. It makes no sense to us, because we have seen the positive results and cannot fathom why the medical community would ignore the success! After reading this latest discussion stemming from the AB article, I thought I'd dig up this old post (#3159 from Sept. 2000) from one of our very valued board contributors, who just happens to be a pediatric orthopaedic surgeon, Dr. son. She took the time to explain her perspective on why some doctors take time to " come around " . I hope some of the newer families enjoy reading her post! Regards, & (3-16-00) left clubfoot Date: Tue Sep 26, 2000 7:21 am Subject: A perspective Hello all, I hope that you don't mind me posting a message as I am a physician rather than a parent. As someone embarking on the Ponseti method I am interested in your thoughts on this method and on any treatment tips I can pass on to my patients' families. I was interested in the thoughts on why the Ponseti method is not widely used and thought that I would contribute my perspective. I have been in practice as a pediatric orthopaedic surgeon since 1994. My training reflects a traditional appproach to clubfeet both from my residency (in Canada) and fellowhip (in the US). I was not taught anything about the Ponseti technique during my training other than a mention that " some people " claimed great success with casting, but that these claims were suspect because they had not been reproduced anywhere else. I can certainly think of several (usually surgical) procedures that have been reported in the literature as great improvements, but are not reproducible by anyone other than the authors. These usually fall by the wayside and that is really where I thought this technique belonged after my training (without really knowing anything else about it). When you start in practice, it is difficult to innovate as you are finding your feet and gradually, over time, you find your own way rather than that of your mentors. This takes a few years. Since I have started in practice, I have always liked clubfeet. Although it is sometimes onerous and time consuming to do the casting (even the " wrong " casting that I started with) I particulary enjoyed the bond that developed in many cases with the families who travelled to see me weekly and biweekly for 2-3 months. The surgery was, in the short term at least, satisfying - to be able to restore a foot to " normal " anatomy. Non-operative success was a rare triumph, and I was never quite sure why I had this occasional success. The casting I started off doing was what I had learned, with no underlying philosophy. For me, a turning point came when I met Fred Dietz about 2 or 3 years ago at a conference and spoke at length about the Iowa experience. Since then I have been gradually incorporating some of the Iowa techniques into my treatment (and improving my non-operative results somewhat). I have to admit that I was afraid to completely divide a baby's Achilles tendon as to weaken the tendon is one of the worst results of any such surgery. It was not until I had the opportunity to see some patients with long term results that I have decided to begin using the tenotomy and the full technique. I now believe that I will not harm my patients. My second turning point was about the 5 year mark in my practice. Now I have 4 and 5 year olds that I alone have treated. In general their feet look good and function well, they and the families are happy. I however have become dissatisfied with the relative stiffness of the feet and worried about the long term. This was not particularly something I learned as a resident, however residents never learn the long term lessons that you get as a graduate following the same group of patients personally. The people who were at the seminar may recall a number of " young " orthopaedic surgeons of about my vintage at the seminar last weekend and I suspect that many of us had similar motives and were looking for an alternative to our training. Will the Ponseti technique catch on? I think so. There was huge interest in it at our Pediatric Orthopaedic Society of North America meeting in May. The work by Dr. Hertzenberg is really important - he has reproduced Iowa results, even just in the short term. What is needed for wide acceptance is a multi-center study demonstrating just such reproducibility with objective evidence - rating scales to make sure that the feet were severe, " real " clubfeet at the start, imaging (xrays and MRIs possibly) to show what is happening to the inside of the foot and to confirm the restoration of normal anatomy, and long-term an analysis of the function of the patients. I believe that this will arise from the recent seminar as we were all talking about banding together to demonstrate these results. Although some may not listen, if those of us who are convinced can demonstrate these things, I believe that the wider pediatric orthopaedic community will listen. Thanks for listening, son Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2004 Report Share Posted July 28, 2004 We often have discussions about " why " the Ponseti method took so darn long to become mainstream. Additionally, we have discussions about why doctors won't follow the method as it was developed, but continue to tweak it. Most of us (I freely admit to being in this group) parents who are not in the medical industry, have our cynical views of why surgeons reject/tweak the method mostly revolving around ego &/or money. It makes no sense to us, because we have seen the positive results and cannot fathom why the medical community would ignore the success! After reading this latest discussion stemming from the AB article, I thought I'd dig up this old post (#3159 from Sept. 2000) from one of our very valued board contributors, who just happens to be a pediatric orthopaedic surgeon, Dr. son. She took the time to explain her perspective on why some doctors take time to " come around " . I hope some of the newer families enjoy reading her post! Regards, & (3-16-00) left clubfoot Date: Tue Sep 26, 2000 7:21 am Subject: A perspective Hello all, I hope that you don't mind me posting a message as I am a physician rather than a parent. As someone embarking on the Ponseti method I am interested in your thoughts on this method and on any treatment tips I can pass on to my patients' families. I was interested in the thoughts on why the Ponseti method is not widely used and thought that I would contribute my perspective. I have been in practice as a pediatric orthopaedic surgeon since 1994. My training reflects a traditional appproach to clubfeet both from my residency (in Canada) and fellowhip (in the US). I was not taught anything about the Ponseti technique during my training other than a mention that " some people " claimed great success with casting, but that these claims were suspect because they had not been reproduced anywhere else. I can certainly think of several (usually surgical) procedures that have been reported in the literature as great improvements, but are not reproducible by anyone other than the authors. These usually fall by the wayside and that is really where I thought this technique belonged after my training (without really knowing anything else about it). When you start in practice, it is difficult to innovate as you are finding your feet and gradually, over time, you find your own way rather than that of your mentors. This takes a few years. Since I have started in practice, I have always liked clubfeet. Although it is sometimes onerous and time consuming to do the casting (even the " wrong " casting that I started with) I particulary enjoyed the bond that developed in many cases with the families who travelled to see me weekly and biweekly for 2-3 months. The surgery was, in the short term at least, satisfying - to be able to restore a foot to " normal " anatomy. Non-operative success was a rare triumph, and I was never quite sure why I had this occasional success. The casting I started off doing was what I had learned, with no underlying philosophy. For me, a turning point came when I met Fred Dietz about 2 or 3 years ago at a conference and spoke at length about the Iowa experience. Since then I have been gradually incorporating some of the Iowa techniques into my treatment (and improving my non-operative results somewhat). I have to admit that I was afraid to completely divide a baby's Achilles tendon as to weaken the tendon is one of the worst results of any such surgery. It was not until I had the opportunity to see some patients with long term results that I have decided to begin using the tenotomy and the full technique. I now believe that I will not harm my patients. My second turning point was about the 5 year mark in my practice. Now I have 4 and 5 year olds that I alone have treated. In general their feet look good and function well, they and the families are happy. I however have become dissatisfied with the relative stiffness of the feet and worried about the long term. This was not particularly something I learned as a resident, however residents never learn the long term lessons that you get as a graduate following the same group of patients personally. The people who were at the seminar may recall a number of " young " orthopaedic surgeons of about my vintage at the seminar last weekend and I suspect that many of us had similar motives and were looking for an alternative to our training. Will the Ponseti technique catch on? I think so. There was huge interest in it at our Pediatric Orthopaedic Society of North America meeting in May. The work by Dr. Hertzenberg is really important - he has reproduced Iowa results, even just in the short term. What is needed for wide acceptance is a multi-center study demonstrating just such reproducibility with objective evidence - rating scales to make sure that the feet were severe, " real " clubfeet at the start, imaging (xrays and MRIs possibly) to show what is happening to the inside of the foot and to confirm the restoration of normal anatomy, and long-term an analysis of the function of the patients. I believe that this will arise from the recent seminar as we were all talking about banding together to demonstrate these results. Although some may not listen, if those of us who are convinced can demonstrate these things, I believe that the wider pediatric orthopaedic community will listen. Thanks for listening, son Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 28, 2004 Report Share Posted July 28, 2004 Thanks for that . As some know, I correspond off list with Dr son every so often and how I thought to do that was by seeing her her post here. I see that she was concerned that parents would find it an imposition for a doctor to post here - for me, I really wish more would! It is the most awsome thing to see that someone in the " industry " is willing to come among the consumers (parents) and hear what they have to say. I have the highest respect for Dr son, as well as for Jay Markell who came to us, the parents, to find out what our concerns and problems were. I absolutely love Dr son and if I were in Canada I would take Kai to her. You can tell from talking to her that she has the deepest of concern and feeling for her patients and is more than willing to admit that sometimes you can learn from the parents. She even asked to see my website to refresh HER memory about plantaris! Imagine, a doctor going to a parent and saying " can you share your information with me? " I cant say enough good about her! lol Angel A perspective Hello all, I hope that you don't mind me posting a message as I am a physician rather than a parent. As someone embarking on the Ponseti method I am interested in your thoughts on this method and on any treatment tips I can pass on to my patients' families. I was interested in the thoughts on why the Ponseti method is not widely used and thought that I would contribute my perspective. I have been in practice as a pediatric orthopaedic surgeon since 1994. My training reflects a traditional appproach to clubfeet both from my residency (in Canada) and fellowhip (in the US). I was not taught anything about the Ponseti technique during my training other than a mention that " some people " claimed great success with casting, but that these claims were suspect because they had not been reproduced anywhere else. I can certainly think of several (usually surgical) procedures that have been reported in the literature as great improvements, but are not reproducible by anyone other than the authors. These usually fall by the wayside and that is really where I thought this technique belonged after my training (without really knowing anything else about it). When you start in practice, it is difficult to innovate as you are finding your feet and gradually, over time, you find your own way rather than that of your mentors. This takes a few years. Since I have started in practice, I have always liked clubfeet. Although it is sometimes onerous and time consuming to do the casting (even the " wrong " casting that I started with) I particulary enjoyed the bond that developed in many cases with the families who travelled to see me weekly and biweekly for 2-3 months. The surgery was, in the short term at least, satisfying - to be able to restore a foot to " normal " anatomy. Non-operative success was a rare triumph, and I was never quite sure why I had this occasional success. The casting I started off doing was what I had learned, with no underlying philosophy. For me, a turning point came when I met Fred Dietz about 2 or 3 years ago at a conference and spoke at length about the Iowa experience. Since then I have been gradually incorporating some of the Iowa techniques into my treatment (and improving my non-operative results somewhat). I have to admit that I was afraid to completely divide a baby's Achilles tendon as to weaken the tendon is one of the worst results of any such surgery. It was not until I had the opportunity to see some patients with long term results that I have decided to begin using the tenotomy and the full technique. I now believe that I will not harm my patients. My second turning point was about the 5 year mark in my practice. Now I have 4 and 5 year olds that I alone have treated. In general their feet look good and function well, they and the families are happy. I however have become dissatisfied with the relative stiffness of the feet and worried about the long term. This was not particularly something I learned as a resident, however residents never learn the long term lessons that you get as a graduate following the same group of patients personally. The people who were at the seminar may recall a number of " young " orthopaedic surgeons of about my vintage at the seminar last weekend and I suspect that many of us had similar motives and were looking for an alternative to our training. Will the Ponseti technique catch on? I think so. There was huge interest in it at our Pediatric Orthopaedic Society of North America meeting in May. The work by Dr. Hertzenberg is really important - he has reproduced Iowa results, even just in the short term. What is needed for wide acceptance is a multi-center study demonstrating just such reproducibility with objective evidence - rating scales to make sure that the feet were severe, " real " clubfeet at the start, imaging (xrays and MRIs possibly) to show what is happening to the inside of the foot and to confirm the restoration of normal anatomy, and long-term an analysis of the function of the patients. I believe that this will arise from the recent seminar as we were all talking about banding together to demonstrate these results. Although some may not listen, if those of us who are convinced can demonstrate these things, I believe that the wider pediatric orthopaedic community will listen. Thanks for listening, son Quote Link to comment Share on other sites More sharing options...
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