We use the terms "Typical" or "Traditional"  Clubfoot
    Treatment to describe methods of correction that are
    outdated yet still used regularly in our modern age of
    medicine despite evidence proving there is a more
    effective way to correct this deformity of the foot.   

    Unfortunately, the majority of parents of children born
    with clubfeet would never know the difference in
    treatment methods, nor that they had a choice.

    The following article was copied from Orthoseek, and
    states plainly how the traditional methods of clubfoot
    treatment progress.  The outlook is grim.  I have
    added my comparative notes between paragraphs in
    red so the reader may better understand the
    difference between Traditional Clubfoot Treatment vs.
    The Ponseti Method which has been around for half a
    century but remains a well kept secret...until now!








Treatment should be started right away. The initial treatment consists of
manipulating the foot to get it to the best position possible, and then
holding the correction in a cast. The cast is changed on a weekly basis,
with manipulation before each casting, to obtain further correction. After
the first 6 weeks, the foot is manipulated and casted every 2 weeks.


(Shawnee's Note:  "Best Possible Position!?!?  Wrong.  The foot should
not be wrenched in to a visually appealing position and casted, as this
article implies.  The tiny bones of your baby's foot should be carefully
positioned according to anatomical correctness, following a particular
sequence of movements.  Done correctly it is a virtually painless process.  
Using the Ponseti Method, the child will most likely be finished with casting
well before 6 weeks are up, and there is no follow up casting "every 2
weeks" as stated in this article.

Furthermore, casting does not need to begin with in the first days of life
"right away".   Using the Ponseti Method serial casting can be delayed until
the age of 2 or 3 weeks with no ill effects, giving parents and family time to
bond and recover, both emotionally and physically, from the birth
experience.)


In 50% of cases, manipulation and casting is successful, and the foot can
then be placed in a thermoplastic brace to hold the correction. In 50% of
cases, manipulation and castings alone do not correct the deformity
completely. At that point somewhere between 3 to 6 months, a
decision will be made regarding further castings, or surgery.

(Shawnee's Note:  The Ponseti Method consistently provides a 95% to 97%
success rate - read it this way:  That is a five percent failure rate
compared to a fifty percent failure rate of traditional treatments
described in this article!  That is a huge difference - with the Ponseti
Method you give your child a fighting chance, not a 50/50 chance.  

Surgery should not even be considered before a child is well in to
their walking/toddler years, and then, only after repeated attempts to
serial cast via the Ponseti Method have been exhausted along with the
parent educated towards proper use of the FAB to maintain the correction,
as failure to use the brace correctly often leads to recurrence of the
clubfooted condition.  See Relapse Rates in side bar)

Some surgeons prefer to wait till the child is about 1 year old before
performing surgery, to allow the foot to get a little larger to facilitate
surgery. Other surgeons operate as early as 3 months of age if it was
clear that further castings will not achieve any more correction.
Your surgeon will have to make that decision with you individually.

(Shawnee's Note:  I cannot scream this loud enough: At age 3 months
old, even at one year old, your child, even if previously treated by
a non-Ponseti method, still has a 90+ % chance of success if the
parent switches to using the Ponseti Method.   Up to two and even
three years of age, the Ponseti Method has succeeded in correcting
clubfeet on children, so do not consider surgery at any point in those first
few years of treatment as casting via the Ponseti Method will likely correct
your child non-surgically - or at least dramatically reduce the amount of
surgery needed. Visit ATTT surgery here.)

After surgery, the foot needs to be casted at biweekly intervals for 6
weeks, followed by the use of a thermoplastic brace, e.g., Wheaton Brace,
to hold the correction. The brace is used full-time for about 6 weeks,
followed by night use only till the child starts to walk at one year of age.

(Shawnee's Note:  Why torture your child with casting, followed by surgery,
followed by more casting for weeks on end followed with a brace that is not
likely to work, therefore the child will endure more surgery at yet another
later date?    

Please note my information regarding the Wheaton Brace linked above,
and explore the Ponseti Method further before you consider any surgical
correction whatsoever.)


Up to the age of one year, there is a 25% chance of recurrence after
surgical correction. Close follow-up is therefore needed. By age one, if the
foot stays well corrected, standing and walking lessens the chance of
recurrence, and the foot usually stays corrected.  


(Shawnee's Note: So even after all those months of casting and surgery
there is still a 25% chance none of it will work?  Those are still lousy odds.

Please read the Iowa Clubfoot Clinic statistics for relapse rates.   There is
still a 80 - 90 % chance of relapse well in to the 2nd year of life, with a 50 -
60 % clear in to the third year when proper bracing is not followed.  
Obviously one year of bracing is not going to finish the job. While there is
some truth that walking does help maintain correction, that alone is not
enough.)

When recurrence occurs, further surgery is needed. In the younger
child, soft tissue releases and lengthenings may suffice. In the older child,
because of bone changes, surgery involving osteotomy (cutting the
bone) is usually needed.

(Shawnee's Note:  Further surgery....  how many surgeries do you want
your baby to have?  Do you want the bones in  your child's foot cut
up?  Why would you even consider this?   Surgery leads to scar
tissue; scar tissues builds up to painful proportions requiring surgery to
remove the scar tissue; since that is surgery, it starts it's own cycle of scar
tissue building up in the bones causing debilitating pain....once started, it's
a vicious cycle with no real ending.

Try to imagine this:  You have a piece of lumber;  you take several nails
and pound them in to the board.  Now pull all the nails out.   Although the
lumber no longer contains the nails, it still contains a lot of holes and the
integrity of the board is lost.   Once you allow a doctor to surgically alter
your child's foot, that foot will remain surgically altered for the remainder of
your child's life.    A surgically altered foot cannot grow in to a normal foot
anymore than the board can heal the nail holes you pounded in to it.

The traditional methods of correcting clubfoot assume surgery will be
required.  Those surgeries have a 75% 'success' rate - with further
surgery needed to correct what the previous surgery screwed up, with so-
called corrective surgeries lasting well in to adulthood in most cases, and a
surgically altered foot for the rest of this child's life.  How "corrective" is
the surgery if it keeps requiring more surgery to correct what it
didn't correct?  Use some common sense here!

A surgically altered foot can not perform like a normal foot, it's physically
impossible.

Remember, the Ponseti Method has a proven 95% non-surgical
success rate, it is non-surgical, it places the bones back in to
their natural and normal order, and is accomplished in an average of five
weeks compared to years of casts and surgeries in the other traditional
methods!)








Clubfoot surgery is difficult, and requires meticulous attention to details.
Even in the best of hands, failures and recurrences can occur. It is
therefore important that the surgery be done by a surgeon experienced in
working with children’s feet.

Shawnee's Note:  That last paragraph says every thing except beware of
all the other risks involved with surgery like infection, heavy duty pain
medications, allergic drug reactions, sedation, surgical errors, nights spent
in a hospital, recovery time, emotional strain on the child and immediate
family, financial costs related to the actual surgery as well as missed days
from work,  and more.

Before you let a doctor work on your child's clubfeet, investigate that
doctor thoroughly!   

Ponseti Rocks! :)

The Ponseti Method of Clubfoot Treatment is
Endorsed by the Following Organizations:


* National Institutes of Health,
* World Health Organization
* Centers for Disease Control
* Pediatric Orthopedic Society of North America
* European Pediatric Orthopedic Society
* American Academy of Orthopedic Surgeons
* American Academy of Pediatrics
* Shriners Hospitals
Clubfoot
Treatment
Return to Clubfoot Treatment Top of Page

Return to Six-feet.com Home Page
Statistics from the
Ponseti Clubfoot
Clinic in Iowa :


".... in our experience,
(children who do not use
the FAB properly) the rate
of relapse is almost 100% in
the first year of life;

80-90% in the second year;

50-60% in the third year;

15-20% in the fourth year,

5-10% in the fifth,

and 6% afterwards."


In short, don't cheat on FAB
wear or you'll only cheat
your child out of good feet.
According to the
Los Angeles Shrine Hospital:
(Traditional Treatment
Methods)

Surgery:

• Multiple surgeries may be
needed to improve foot position.
Rigid clubfeet often require
release of tight soft tissues and
may require surgical realignment
of bones, both of which are usually

performed during infancy.

Persistent cases may require
more surgical correction in later
childhood and adolescence.

Clubfoot surgery accounts for
80% of foot surgeries at SHC-LA.

http://www.shrinershq.org
/Hospitals/Los_Angeles/c
onditions/Club_feet.aspx

Those are some pretty dire
words.  If this sounds at all like
your current doctor / hospital,
please (!) look further!   Not all
Shrine Hospitals are the same.  
The St. Louis Missouri Shrine
practices the Ponseti Method with
very good success!   

Learn More About Non-Surgical
Clubfoot Correction Here at Six-
feet.com