delay in tenotomy - pro or con?

August 27, 2005

My son Jack (6 months old) has bilateral club feet Left foot much

worse than the right. He had been in casts from 3 days old 'til 6

weeks and then on to the Markel shoes and DDB until now. One week

ago his left foot had horrible pressure blisters and we have had the

shoes off for a week now to heal. - Every time we have tried

to put them back on the blisters re-emerge. We have tried heel pads,

tongue pads, different strap arrangements, socks...everything

recommended on this site - but with no result.

I went back to the doctor last week and he scheduled the tenotomy the

end of Sept. Jack will be 7 months old by then. If my doctor was

faithful to the Ponseti method, we would have had the tendon release

by now...it was put off because the shoes WERE working well and we

were hoping to avoid the procedure.

So, what is the harm or benefit of waiting another month? If the

doctors schedule won't permit should we just find another Dr? Or is

it worth chucking months of work with one to go to another over a two

weeks wait?

August 29, 2005

How long was Jack wearing the shoes before he started having problems?

It sounds like his feet have either lost correction or were never

fully corrected to begin with. You are correct that the tenotomy is

normally performed prior to going into the shoes, but there are cases

where the tenotomy is not needed if there is sufficient dorsiflexion.

I would say the harm in waiting another month is that your son will

probably lose correction if he is not staying in the shoes (due to

having to keep them off because of blisters) and then he will not be

ready for the tenotomy. Is your doctor Ponseti approved? If he is

not on the list, or even if he is and is modifying the method I would

likely say that you should get him to another doc for a second

opinion. Where are you located? We can definitely try to help you

find a certified doctor who is close to you.

> My son Jack (6 months old) has bilateral club feet Left foot much

> worse than the right. He had been in casts from 3 days old 'til 6

> weeks and then on to the Markel shoes and DDB until now. One week

> ago his left foot had horrible pressure blisters and we have had the

> shoes off for a week now to heal. - Every time we have tried

> to put them back on the blisters re-emerge. We have tried heel pads,

> tongue pads, different strap arrangements, socks...everything

> recommended on this site - but with no result.

>

> I went back to the doctor last week and he scheduled the tenotomy the

> end of Sept. Jack will be 7 months old by then. If my doctor was

> faithful to the Ponseti method, we would have had the tendon release

> by now...it was put off because the shoes WERE working well and we

> were hoping to avoid the procedure.

>

> So, what is the harm or benefit of waiting another month? If the

> doctors schedule won't permit should we just find another Dr? Or is

> it worth chucking months of work with one to go to another over a two

> weeks wait?

August 29, 2005

I'm in Albany NY. We are 3 hours from NYC where I see the most doctors but

Shriners Hosp in Mass is very close and there is a certified ponseti Dr.

There. I am concerned b/c I have tried to put the shoes back on and they

keep working loose. I am afraid that he may have already lost correction.

Reply-To: nosurgery4clubfoot

To: nosurgery4clubfoot

Subject: Re: delay in tenotomy - pro or con?

Date: Mon, 29 Aug 2005 15:57:03 -0000