Guest guest Posted April 2, 2004 Report Share Posted April 2, 2004 Hello. Leah was born 12-18-03 with severe bilateral clubfoot. She had 7 castings, then tenotomies. Her feet corrected very well, and a surprisingly flexible. She just came out of the post-op casts after 6 weeks. She is now in AFOs and the DBB, and seems to be adjusting well. We noticed after getting home from her cast removal that her right foot appears to be slightly more rounded on the bottom than her left. The ortho didn't comment on this when he took the casts off, but he seemed unusually distracted during the visit, which isn't normal for him. Has anybody else encountered this? We are assuming she developed some sort of rocker bottom deformity while in the last casting. We haven't called the ortho yet. Her grandmother is an OT, and has shown us how to avoid further " harming " the foot while doing stretches. If the rocker bottom is only from her last casting, will it likely correct itself? Her feet look great otherwise. Her right foot corrected much easier than the left did during the serial castings. thanks, Rob, , Leah Graham (12-18-03, bil club, tenotomy 2-19-04) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 2, 2004 Report Share Posted April 2, 2004 Rob & , Vinny had the same problem and his doctor and physical therapists all commented on him having the 'rocker-bottom' when his last casts came off. They weren't overly concerned about it and said to watch his feet when he spends the hour out of his shoes. Gradually the rocker bottom leveled out. As I understood it, the rounded bottom was excess fat that built up. Being in the casts, he was unable to apply pressure to the bottoms of his feet like other babies would normally do. I was given a series of exercises to do with him during the hour out. The excercise I was given to work off the pudge and keep him flexible was what I call a bootie dance. This can be done in or out of shoes. Stand him up, get him to bend a bit at the waist and knees so his butt was sticking out and his weight was on his heels. Then he would just bounce on his own. (The bootie dance). He loved this exercise after a couple of months the fat one the bottom became less and less. Now he has a nicely shaped foot print that even includes an arch! It was amazing when I first noticed the little arch showing. I really felt progress was being made then. He still has pudgy feet but the bottoms aren't round anymore. I wouldn't worry too much about it unless it doesn't go away. But start the bootie dance! It's fun for both of you! Laurie - Vinny's mommy > Hello. Leah was born 12-18-03 with severe bilateral clubfoot. She had 7 > castings, then tenotomies. Her feet corrected very well, and a surprisingly > flexible. She just came out of the post-op casts after 6 weeks. She is now > in AFOs and the DBB, and seems to be adjusting well. We noticed after > getting home from her cast removal that her right foot appears to be > slightly more rounded on the bottom than her left. The ortho didn't comment > on this when he took the casts off, but he seemed unusually distracted > during the visit, which isn't normal for him. Has anybody else encountered > this? We are assuming she developed some sort of rocker bottom deformity > while in the last casting. We haven't called the ortho yet. Her grandmother > is an OT, and has shown us how to avoid further " harming " the foot while > doing stretches. If the rocker bottom is only from her last casting, will > it likely correct itself? Her feet look great otherwise. Her right foot > corrected much easier than the left did during the serial castings. > > thanks, > Rob, , Leah Graham (12-18-03, bil club, tenotomy 2-19-04) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 2, 2004 Report Share Posted April 2, 2004 What is exactly is rocker bottom? Simon's foot have always been like a round flat look. Not an arch at all. I just thought that all c/f looked that way? Does it eventually go away? My doc has never even brought it up so I figured it was " normal " for a clubfoot baby? > >Reply-To: nosurgery4clubfoot >To: nosurgery4clubfoot >Subject: Re: rocker bottom question >Date: Fri, 02 Apr 2004 14:53:56 -0000 > >Rob & , > >Vinny had the same problem and his doctor and physical therapists all >commented on him having the 'rocker-bottom' when his last casts came >off. They weren't overly concerned about it and said to watch his >feet when he spends the hour out of his shoes. Gradually the rocker >bottom leveled out. As I understood it, the rounded bottom was >excess fat that built up. Being in the casts, he was unable to apply >pressure to the bottoms of his feet like other babies would normally >do. I was given a series of exercises to do with him during the hour >out. The excercise I was given to work off the pudge and keep him >flexible was what I call a bootie dance. This can be done in or out >of shoes. Stand him up, get him to bend a bit at the waist and knees >so his butt was sticking out and his weight was on his heels. Then >he would just bounce on his own. (The bootie dance). He loved this >exercise after a couple of months the fat one the bottom became less >and less. Now he has a nicely shaped foot print that even includes >an arch! It was amazing when I first noticed the little arch >showing. I really felt progress was being made then. He still has >pudgy feet but the bottoms aren't round anymore. >I wouldn't worry too much about it unless it doesn't go away. But >start the bootie dance! It's fun for both of you! >Laurie - Vinny's mommy > > > Hello. Leah was born 12-18-03 with severe bilateral clubfoot. She >had 7 > > castings, then tenotomies. Her feet corrected very well, and a >surprisingly > > flexible. She just came out of the post-op casts after 6 weeks. She >is now > > in AFOs and the DBB, and seems to be adjusting well. We noticed >after > > getting home from her cast removal that her right foot appears to >be > > slightly more rounded on the bottom than her left. The ortho didn't >comment > > on this when he took the casts off, but he seemed unusually >distracted > > during the visit, which isn't normal for him. Has anybody else >encountered > > this? We are assuming she developed some sort of rocker bottom >deformity > > while in the last casting. We haven't called the ortho yet. Her >grandmother > > is an OT, and has shown us how to avoid further " harming " the foot >while > > doing stretches. If the rocker bottom is only from her last >casting, will > > it likely correct itself? Her feet look great otherwise. Her right >foot > > corrected much easier than the left did during the serial castings. > > > > thanks, > > Rob, , Leah Graham (12-18-03, bil club, tenotomy 2-19-04) > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2004 Report Share Posted April 5, 2004 I believe that true " rocker bottom " is the breakdown of the mid- section of the foot. It has to do with the bone structure, and shouldn't have to do with fat deposits. With our first doctor (pre- Ponseti), started to develop rocker bottom from casting/AFO's. Hopefully you can get an appointment with your doctor to follow up. I am assuming that your doctor conducted more than a subcutaneous tenotomy on Leah since she had 6 weeks of post-op casting per your email. Was it actually a " release " procedure (open incision) that they completed? As you probably know, standard Ponseti protocol is a subcutaneous tenotomy (no stitches) with a 3 week cast, then into the foot abduction brace. FYI, you might want to research a bit on the AFO's since the U of Iowa found that the FAB is more successful than the AFO in preventing relapse. Did your doctor " over correct " Leah's feet? Are the shoes on the brace set to 70 degrees outward rotation? I would recommend getting in for a follow up appointment to check the rocker bottom and not hope that it resolves on it's own. Please keep us posted! & (3-16-00) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2004 Report Share Posted April 6, 2004 >I am assuming that your doctor conducted more than a subcutaneous >tenotomy on Leah since she had 6 weeks of post-op casting per your >email. Was it actually a " release " procedure (open incision) that >they completed? >Did your doctor " over correct " Leah's feet? I stand corrected. He did a release of the Achilles instead of a tenotomy. He seems to have followed Ponsetti up to that point, correcting her feet with 7 weekly castings before the release. Her feet are over corrected. The bottom of her foot looks better already. The rounding may have just been fat deposit as was suggested in another email. Rob, , Leah Graham Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2004 Report Share Posted April 6, 2004 >I am assuming that your doctor conducted more than a subcutaneous >tenotomy on Leah since she had 6 weeks of post-op casting per your >email. Was it actually a " release " procedure (open incision) that >they completed? >Did your doctor " over correct " Leah's feet? I stand corrected. He did a release of the Achilles instead of a tenotomy. He seems to have followed Ponsetti up to that point, correcting her feet with 7 weekly castings before the release. Her feet are over corrected. The bottom of her foot looks better already. The rounding may have just been fat deposit as was suggested in another email. Rob, , Leah Graham Quote Link to comment Share on other sites More sharing options...
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