Guest guest Posted October 25, 2004 Report Share Posted October 25, 2004 Just a question--I am just wondering if somebody could tell me a little more about AFO's--why doesn't Dr. Ponseti use them/think they work? This has probably been discussed before my time!! Thanks! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 25, 2004 Report Share Posted October 25, 2004 > > Just a question--I am just wondering if somebody could tell me a > little more about AFO's--why doesn't Dr. Ponseti use them/think they > work? This has probably been discussed before my time!! > Thanks! > Hi , Basically it's because the AFO, being a free moving 'boot', doesn't maintain the outward rotation of the foot, which is vital to prevent relapse. With the FAB, and its integral bar, the feet are held outward at a 70 degree angle. It's my understanding that, back in the '80s, during Dr. Ponseti's brief retirement, the doctors in Iowa tried AFOs for a while, but saw an increase in relapses, and realized they would not work. Perhaps some parents who have experienced both the AFO and FAB will tell you more.. but I have heard that, although the AFO 'sounds' better in theory, it's not all that easy to deal with. Most parents, though initially fearful of the FAB, find that it's actually much easier to use, and for the baby to adjust, than they expect. (See our poll here on the subject.) Below is an excerpt on bracing from the Ponseti " Global Health " booklet (link below). It discusses the KAFO (knee ankle foot orthotic), and perhaps the AFO (ankle foot orthotic) in this sentence, though I'm not sure: " Some braces are no better than the shoes by themselves. " .......................... 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, 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/ponseti-cf.html and Claire Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 26, 2004 Report Share Posted October 26, 2004 " The magic is in the bar, not the shoes " , as they all say. The AFO's cannot hold the 70 degree rotation like the bar. That is why they can relapse in the AFO's. My daughter is an example of that. Now I have $1500.00 pieces of useless equipment. Shook Retail Operations Manager/Baking Instructor Vie de France Yamazaki, Inc. 2070 Chain Bridge Rd. Suite 500 Vienna, VA 22182 x374 x374 fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 26, 2004 Report Share Posted October 26, 2004 Yes, lots of talk here about those but in brief, they don't have the bar to maintain the correct angles. s. AFO's Just a question--I am just wondering if somebody could tell me a little more about AFO's--why doesn't Dr. Ponseti use them/think they work? This has probably been discussed before my time!! Thanks! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 26, 2004 Report Share Posted October 26, 2004 , Here is some information about your question on why AFO's are not used in the Ponseti method. A message from from July 2004 regarding her experience with AFO's http://health.groups.yahoo.com/group/nosurgery4clubfoot/message/22282 A follow up message to 's with references to articles and Dr. Ponseti's statements on AFO's http://health.groups.yahoo.com/group/nosurgery4clubfoot/message/22284 Additional FAB/DBB Information from a post from at http://health.groups.yahoo.com/group/nosurgery4clubfoot/message/25824 I hope that this helps. > > Just a question--I am just wondering if somebody could tell me a > little more about AFO's--why doesn't Dr. Ponseti use them/think they > work? This has probably been discussed before my time!! > Thanks! > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 26, 2004 Report Share Posted October 26, 2004 lol I got you beat I have 2 pairs totalling 3000.00! Yes she is right the afos did nothing for Tyler except cause me a really big headache in the head and the wallet! Spend the time and money on the bar braces they maintain the correction and only take a little bit more getting used to. Tyler's mommy bi lateral atypical cf 1/14/03 Dobbs brace 9/9/04 16/7 4/12/94 non cf 5/24/95 non cf > " The magic is in the bar, not the shoes " , as they all say. The AFO's > cannot hold the 70 degree rotation like the bar. That is why they can > relapse in the AFO's. My daughter is an example of that. Now I have > $1500.00 pieces of useless equipment. > > > > > Shook > Retail Operations Manager/Baking Instructor > Vie de France Yamazaki, Inc. > 2070 Chain Bridge Rd. Suite 500 > Vienna, VA 22182 > x374 > x374 > fax > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 26, 2004 Report Share Posted October 26, 2004 lol I got you beat I have 2 pairs totalling 3000.00! Yes she is right the afos did nothing for Tyler except cause me a really big headache in the head and the wallet! Spend the time and money on the bar braces they maintain the correction and only take a little bit more getting used to. Tyler's mommy bi lateral atypical cf 1/14/03 Dobbs brace 9/9/04 16/7 4/12/94 non cf 5/24/95 non cf > " The magic is in the bar, not the shoes " , as they all say. The AFO's > cannot hold the 70 degree rotation like the bar. That is why they can > relapse in the AFO's. My daughter is an example of that. Now I have > $1500.00 pieces of useless equipment. > > > > > Shook > Retail Operations Manager/Baking Instructor > Vie de France Yamazaki, Inc. > 2070 Chain Bridge Rd. Suite 500 > Vienna, VA 22182 > x374 > x374 > fax > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2004 Report Share Posted October 28, 2004 Wow , what a bummer! Maybe we should collect all the unused AFO's from this site and connect them to make a chain like " Hands Across America " except we would be " Feet Across America " . Shook Retail Operations Manager/Baking Instructor Vie de France Yamazaki, Inc. 2070 Chain Bridge Rd. Suite 500 Vienna, VA 22182 x374 x374 fax Quote Link to comment Share on other sites More sharing options...
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