Re: Re: FAB/DBB tips and tricks - for Parents new to the brace

[Guest guest]

Thanks Louisa. 's doctor feels that kids tolerate the straight

last better and he does seem to do better in them, so you might want to

switch to those when Zoe needs a new pair. Of course, whatever you and she

are comfortable with is best. The only reason had to go in them

at first was because the orthotist we had said they didn't make the straight

last shoes in the small size he needed....either that or they just didn't

have any.

and

BCF 03/25/2004

DBB 23/7

Re: FAB/DBB tips and tricks - for Parents new

to the brace

> ,

> I am so glad is doing well! The 8 degree issue was from

> Jay Markell back on May 26th when I asked about reverse last shoes.

> Zoe has them too and they are set at 60 degrees for both feet, even

> though she is RCF, so I guess she is at about 68 degrees altogether.

> Here is what he wrote.

>

> Quote

> Dear Louisa et at,

>

> Historically, the reverse last boots have been used to maintain

> correction after casting. The open-toe reverse last boot that we make

> provides about 8 degrees of abduction or outflare in the forefoot.

>

> Dr Ponseti used this shoe as a means of maintaining correction on

> the Denis Browne Bar, years ago, prior to his evolving the treatment

> to today's standard. Back then I believe he was not correcting the

> feet out to 70 degrees external, or that after casting he was not

> holding the feet on the DBB at 70. In that situation the outflare of

> the shoe helped to turn the foot out beyond what the bar was doing.

> Now, today, since it was found that 70 degrees of external rotation

> on the clubfoot(feet) can be tolerated and is more effective in

> maintaining correction and preventing relapse, Dr. Ponseti and others

> no longer find the need to use the outflare open-toe boot. They

> switched to the straight last boot.

>

> Some Docs still use reverse last boots. It is not a bad thing. Some

> might say that it is overkill, or perhaps a " belt and suspenders "

> approach.

>

> I hope this clarifies things a little for you.

>

> Jay Markell

> Unquote

>

> I am going to ask for straight last when she grows out of these, but

> from reading above, it does not really seem to matter.

>

> Louisa

> 6-27-99

> Zoe 2-22-04 RCF

>

>

>

> > > >My son has bilateral clubfoot and when he first went into the

> shoes, his

> > > >were set at 45 degrees as well. I did ask the doctor about

> that. The

> > > >reason my son's were set at 45 degrees at first was because he

> was

> > wearing

> > > >the reverse last shoe. These shoes have a bend in them and each

> shoe has

> > to

> > > >go on the correct foot. He is now in the straight last shoes,

> which can

> > go

> > > >on either foot, and the angle was changed to 70 degrees. Are

> 's

> > shoes

> > > >the reverse last ones? If so, then the 45 degree angle is fine

> because

> > the

> > > >bend in the shoes also adds to the angle, so you don't want

> those to be

> > at

> > > >70 degrees.

> > > >

> > > > and

> > > >BCF 03/25/2004

> > > >DBB 23/7

> > >

> > >

> > >

> > >

> > >

[Guest guest]

At 11:34 AM 8/4/2004, you wrote:

>The only reason had to go in them

>at first was because the orthotist we had said they didn't make the straight

>last shoes in the small size he needed....either that or they just didn't

>have any.

They're making the straight last shoes in 0000's now and have been since

October of last year. Just a FYI for anyone who is going into the FAB/DBB

with a little one. They used to only make them in 000's but with the new

style that came out (enlarged heel pocket, ankle padding, and tongue

padding) they also added the 0000's. So anyone who tells you they don't

make them that small, print out the Markell PDF from the files section

(make sure to print it at 100%, there's a sizing chart there and it'll be

wrong if you don't make sure it's 100%) and take that to them. It says

right on the flyer front page they're available in 0000's. Just because

they don't have something in stock it doesn't mean they can give you

whatever they have if it's not appropriate. Same with the old style shoes

- if you want the new style they should order it for you. Especially if

you're paying out of pocket or insurance, whatever. Even Shriners has

ordered us new style shoes because I asked for them (well, perhaps since

she had the sore problems they've been extra lenient with me but I still

would have pleaded for the new shoes once I knew they were available and

probably got them).

Well hummm... I went to look for the PDF and it's not there. That's

weird... I know Jay uploaded them last October, on both groups. Time for

some investigating I think...

Kori

Mama of

Kenton - 6/98

Merek - 3/00

Darbi - 3/28/03 - Rt. CF - DBB 12hr/d

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