Re: question about different types of braces?

[Guest guest]

Wheaton Braces are a type of KAFO of (knee-ankle-foot-orthotic).

They are mentioned in the Global HELP publication on the Ponseti

method that was coauthored by Dr. Ponseti.

Dr. Ponseti does not use AFO's or KAFO's in his method. He feels

that since they don't maintain the external rotation of the foot

that they allow the foot to relapse easier. In the recent Global

HELP Publication on the Ponseti method it says on page 15,

" Importance of bracing "

" The Ponseti manipulations combined with the percutaneous

tenotomy regularly achieve an excellent result. However,

without a diligent follow-up bracing program,recurrence and

relapse occur in more than 80% of cases. This is in contrast to

a relapse rate of only 6%in compliant families (Morcuende et

al.). "

" Alternatives to foot abduction brace "

" Some surgeons have tried to " improve " Ponseti management

by modifying the brace protocol or by using different braces.

They think that the child will be more comfortable without the

bar and so advise use of straight last shoes alone. This strategy

always fails. The straight last shoes by themselves do nothing.

They function only as an attachment point for the bar. "

" Some braces are no better than the shoes by themselves

and, therefore, have no place in the bracing protocol. If well

fitted, the knee-ankle-foot braces (KAFO's), such as the Wheaton

brace, maintain the foot abducted and externally rotated. However,

the knee-ankle-foot braces keep the knee bent in 90 degrees

of flexion. This position causes the gastrocnemius muscle and

Achilles tendon to atrophy and shorten, leading to recurrence of

the equinus deformity. This is particularly a problem if a knee-

ankle-foot brace is used during the initial 3 months of bracing,

when the braces are worn full time. "

" In summary, only the brace as described by Ponseti is an

acceptable brace for Ponseti management and should be worn

at night until the child is 3 to 4 years of age. "

http://www.global-help.org/publications/pdfs/PonsetiBook.pdf

A link to the Wheaton Brace web site can be seen at

http://www.wheatonbrace.com/products/wbsys.html

and (3-17-99)

> My son is 11 months old, he was casted for four weeks when he was

> first born, had the surgery at 3months and then recasted, since

> about 4 months he has been in the DDB. My first question is what

is a

> AFO? Second has anyone ever heard of th wheaton bracing system it

> just goes on one leg? The reason for my question is my son is not

> sleeping very well, he moves a lot in his sleep and is having

> difficulty getting to sleep, it seems as the older he gets the

harder

> it is for him to sleep with the brace on. Since he is not sleeping

> well either is mom. I went to a medical supply place and they

found

> this wheaton bracing system in their catalog. My doctor, Dr.

Carrio,

> in NY who is absolutely wonderful says he will give it a try, but

he

> wants to see it so he can decide whether it will rotate his foot

and

> keep it at the correct angle. Before I buy this has anyone had any

> experience with this? thanks for any help, suggestions or comments

[Guest guest]

Does your son currently have the FAB(DBB)? If so, is it set to the

correct width? Many of the parents here, myself included, have found

that if the width of the brace becomes too narrow (as the child

grows), it can become very uncomfortable for the child and greatly

affects the sleeping pattern. Widening the bar to a more comfortable

width usually remedies the problem.

The length of the bar should be set so that the inside edges of the

heels of the shoes are roughly equal to the width of the child's

shoulders.

Hope this helps,

Daiga and Owen, 02/04/03

Unilateral LCF, FAB 14/24

> My son is 11 months old, he was casted for four weeks when he was

> first born, had the surgery at 3months and then recasted, since

> about 4 months he has been in the DDB. My first question is what is

a

> AFO? Second has anyone ever heard of th wheaton bracing system it

> just goes on one leg? The reason for my question is my son is not

> sleeping very well, he moves a lot in his sleep and is having

> difficulty getting to sleep, it seems as the older he gets the

harder

> it is for him to sleep with the brace on. Since he is not sleeping

> well either is mom. I went to a medical supply place and they found

> this wheaton bracing system in their catalog. My doctor, Dr.

Carrio,

> in NY who is absolutely wonderful says he will give it a try, but

he

> wants to see it so he can decide whether it will rotate his foot

and

> keep it at the correct angle. Before I buy this has anyone had any

> experience with this? thanks for any help, suggestions or comments