After a child or baby with clubfoot has received serial castings via the Ponseti Method, the next step is the maintenance phase, which is wearing a brace to hold the corrected foot in the right position so that there is not a relapse.
(Picture by globalclubfoot.org)
Studies have shown a 90% (or better) success rate when a child or infant wears a brace after their castings. Here are a few different types of braces for clubfoot.
The Dobbs Brace was invented in 2007 by Dr. Matthew B. Dobbs, and has a bar connecting the feet with a release mechanism that allows parents to easily detach and reattach the bar to place the child in a car seat or high chair, or change a diaper without removing the entire brace.
The Dobbs Brace also allows children to move their legs independently while wearing the brace. Dobbs said these changes are key to preventing a recurrence of clubfoot: “Just having the flexible bar makes a huge difference in compliance and convenience.”
The Ponseti AFO Brace (also known as the Mitchell brace) has been available since 2005. It’s more expensive than most foot abduction braces, but is said to be more comfortable and easier for the baby to adjust to. Dr Ponseti was involved in the design of the Ponseti AFO/ Mitchell brace and it is especially recommended for children with very small feet or complex clubfoot.
The setup of the bars and shoes is according to Dr. Ponseti’s protocol and should not be altered, unless the clubfoot is complex. It’s essential that the foot is corrected 100% before starting in the shoes, and also that the foot doctor fitting the shoes is competent in the Ponseti method and knows how to set them up correctly.
The Steenbeek Foot Abduction Brace (SFAB) was designed in Uganda by Michiel Steenbeek, and endorsed by Dr, Ponseti, and is an effective low-cost option for developing countries.
If parents have to buy braces at full cost this may put them into severe financial difficulty which may eventually result in them stopping treatment.
However, some programs have found that asking parents for a minimal contribution towards the brace as a deposit can help with adherence and means parents take better care of the brace.
If your child has clubfoot, or you suspect that he or she has clubfoot, then you need to seek out a qualified clubfoot doctor who is trained in the Ponseti Method of clubfoot correction. Contact our clubfoot doctors at the Clubfoot Institute by calling (877) FOOT-911. We are here to help you and your child.
