Dr. Ponseti's response to severity/relapse and length of time in the FAB

[Guest guest]

Hello all,

I usually talk to Dr. Ponseti once a week if not every other week and I

always keep him informed about the topics of discussion on our support

group. The latest discussion of severity / relapse and length of time in the

bar has left me frustrated at times. Although I understand where Dr. Ponseti

stands on this issue I asked him to respond to me in an email that I could

share with all of you.

Here is the email:

May 14, 2004

The incidence of relapse is mostly related to failure of compliance with the

use of the foot abduction brace. However even with a good discipline of

brace wear relapses occur in about 5% of patients. These relapses occur

proportionately with the severity of the original deformity as in patients

who require seven or eight casts and where the heel is in severe varus and

equinus with skin folds across the sole of the foot. These children may need

to wear the brace at night and naptime for at least 3 1/2 to 4 years. The

majority of patients who have a moderate clubfoot deformity which was

corrected with five plaster casts will need to wear the brace until about 3

years of age. The decision to remove the brace at this age is easy to make

if the foot is very pliable and it can be easily abducted (turned out). In

cases where the ligaments are stiff and the joints of the foot are not

supple, then it is safer to wear the brace at night until four years of age.

I.V. Ponseti, M.D.

If anyone has any further questions please let me know and I would be glad

to help clarify things. Terese wrote an email a few days ago and addressed

these same issues quite well. I too am a parent of an almost four year old

boy who had moderate to severe bilateral clubfeet and today his feet look

beautiful, thanks to Dr. Ponseti!!

I hope this helps clarify things for everybody!

Charity and Trenton (8-24-00)

Still in the bar at nights

P.S. We just got a size 8 shoe and new gold bar, which my son was excited

about!!! The memories of the FAB for Trenton are good, he calls them his

night time shoes. He was also very excited to measure his feet for new night

time shoes! He is a active boy and challenges many things in his little

life, but his shoes aren't one of them it's a part of him!! : )

[Guest guest]

Bless you Charity! Aren't you cool! Thank you so much. What a

concept... ask Dr. Ponseti LOL!

Kori

At 04:07 PM 5/17/2004, you wrote:

>Hello all,

>

>I usually talk to Dr. Ponseti once a week if not every other week and I

>always keep him informed about the topics of discussion on our support

>group. The latest discussion of severity / relapse and length of time in the

>bar has left me frustrated at times. Although I understand where Dr. Ponseti

>stands on this issue I asked him to respond to me in an email that I could

>share with all of you.

>

>Here is the email:

>

>May 14, 2004

>The incidence of relapse is mostly related to failure of compliance with the

>use of the foot abduction brace. However even with a good discipline of

>brace wear relapses occur in about 5% of patients. These relapses occur

>proportionately with the severity of the original deformity as in patients

>who require seven or eight casts and where the heel is in severe varus and

>equinus with skin folds across the sole of the foot. These children may need

>to wear the brace at night and naptime for at least 3 1/2 to 4 years. The

>majority of patients who have a moderate clubfoot deformity which was

>corrected with five plaster casts will need to wear the brace until about 3

>years of age. The decision to remove the brace at this age is easy to make

>if the foot is very pliable and it can be easily abducted (turned out). In

>cases where the ligaments are stiff and the joints of the foot are not

>supple, then it is safer to wear the brace at night until four years of age.

>

>I.V. Ponseti, M.D.

>

>If anyone has any further questions please let me know and I would be glad

>to help clarify things. Terese wrote an email a few days ago and addressed

>these same issues quite well. I too am a parent of an almost four year old

>boy who had moderate to severe bilateral clubfeet and today his feet look

>beautiful, thanks to Dr. Ponseti!!

>

>I hope this helps clarify things for everybody!

>

>Charity and Trenton (8-24-00)

>Still in the bar at nights

>

>P.S. We just got a size 8 shoe and new gold bar, which my son was excited

>about!!! The memories of the FAB for Trenton are good, he calls them his

>night time shoes. He was also very excited to measure his feet for new night

>time shoes! He is a active boy and challenges many things in his little

>life, but his shoes aren't one of them it's a part of him!! : )

>

>

>