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,

We had always set 's bar width from heel to heel = shoulders. He's

definitely more comfortable with this. I queried with Dr Ponseti a

while ago after I saw that the Iowa literature was different. Here is

his reply below. Seems like anything from bolt to bolt outwards is

fine, depends on what your child is most comfortable with.

and

www.clubfoot.co.za http://www.clubfoot.co.za/>

Moss - South Africa

Dear Dr Ponseti

I need to clarify the exact setting of the width of the bar. I'm a

little confused about it. I think that when we were in Iowa, we were

told that it was heel-to-heel = shoulder width. But then

Hall's documents said the measurement between the centre of the bolts

was the correct measurement place and not the heel.

We have always done the heel-to-heel measurement and it seems to be very

comfortable for . His bar has just been extended. He had the large

size adjustable Fillauer, but it was right at the edge already. They

welded on extensions and re-painted it for us, it's a little heavier

now, but seems to be working fine.

The orthotist here told us that it is definitely bolt-to-bolt and that

heel-to-heel is too wide. He said it is mentioned in your book. This

is how he sets the bars for the other babies.

But since he made it narrower, is waking up more at night. He is

usually a very good sleeper. He just seems more comfortable when the

bar is a little wider (heel to heel measurement). Can we safely make

the bar a little wider, or will it affect him somehow.

Regarding publicity for the method, I have arranged a TV interview about

the growth of the Ponseti Method in South Africa and Uganda, it is being

recorded tomorrow and will be broadcast within the next few days. Also,

an article about the Ponseti Method, our experience and interviews with

Dr's Eltringham and Khan will be in June issue of TLC magazine. It is a

South African medical magazine distributed to doctors waiting rooms,

hospitals, etc. They have a readership of 2 million.

Best regards,

Moss

www.clubfoot.co.za http://www.clubfoot.co.za/>

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Thanks everybody for your responses! Except now I'm still confused!!

Theresa's response (and the sections from the literature you posted)

made me think it's definitely heel to heel measurement. But from the

letter posted from Dr. Ponsetti, it seems bolt to bolt is

correct!!! I guess as long as your (my) baby is comfortable, and

it's not causing any harm to the correction, it doesn't really

matter too much. What turns me in favor of the bolt to bolt

measurement is what I said before -- on a 6 " bar, a heel to heel

measurement is only going to be about 3 " , which is crazy! (I have

the red non-adjustable bar) But the bolt to bolt measurement is

about 6 " , which is her shoulder width. But babies are like anybody

else, and what's comfortable to one may be annoying to another!

Thanks,

mommy of:

Guinevere, on, Ava 8/4/04 right CF DBB 23/7 (day 9...)

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  • 2 weeks later...

I understand your concern about measuring between bolts and heels.

However your overall feel about whether your baby is comfortable or

not, is the most important one.

I have to confess I didn't/don't worry about it so literally. I look

at my son's shoulder width, add on an inch, check visually only that

I feel it isn't too close or too far apart and just go for it. It is

very simple for me as he will let me know in some way and you can

tell really just by watching. If it is too close you can bet your

bottom dollar that he'll be out of them before you can say jack

rabbit ;)

Good luck

mum to who has bilateral talipes

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