Club Foot

Hi.

I am new to this sight. My son, Alex, is ten and was born with bilateral club feet. He was in casts from the first day of his life, had complete foot reconstruction at 4 months and wore full leg casts for 2 months, followed by 1/2 leg casts until he was one. He then wore "the shoes" for a year, at night only.

His feet were deemed "perfect" and we have been so happy! The doctor told us if any further surgery was needed it would be prior to Kindergarten. Were we ever happy when that date came and passed with "all clear" from the doctor.

Since them, we have visited the doctor and had x-rays every two years. Alex plays every sport imaginable and is VERY active. Just recently my husband and I, Alex's coaches, babysitter and teacher have been commenting that he seems to be limping. We have an appointment on Wednesday with the specialist.

I am wondering if there are any parents out there that have had a similar "relapse" so long after surgery? What is "too late" for more corrective surger? Are there other alternatives?

Any feedback would be much welcomed.

Thanks,
Mindy
mcc340@aol.com

Hi Mindy,

I'm sorry your son is having difficulty .. it must be hard to have it happen all of a sudden after so many good years.. It's great that he's so active.

I have seen one journal article which mentioned a late relapse .. here's the abstract.

"Clin Orthop Relat Res. 2003 Jun;(411):188-92. Related Articles, Links

Late recurrence of clubfoot deformity: a 45-year followup.

Dobbs MB, Corley CL, Morcuende JA, Ponseti IV.

Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, MO 63110, USA. mattdobbs@earthlink.net

Idiopathic clubfoot is one of the most common congenital deformities. Regardless of the mode of treatment, clubfoot has a tendency to relapse until the age of 5 years. Relapses are rare in patients after 5 years of age. A 45-year followup of a patient with idiopathic clubfoot treated as a newborn with the Ponseti method is reported. The patient had both clubfeet well-corrected as seen clinically and radiographically with this method. However, recurrent deformities developed bilaterally when the patient was 8 years old. Because of the late recurrence of this deformity, the patient had a thorough neurologic evaluation, which was normal. Treating physicians should be aware of the possibility of late recurrence in patients who have had complete correction of their clubfoot deformity."

It doesn't say anything further in the abstract.. but maybe you could get a full copy of the article, or even contact Dr. Dobbs.

It's possible that a tendon transfer would be helpful.. there's information on that procedure below:

Link to a messageboard post including text about Dr. Ponseti's 2001 article regarding relapses:
http://groups.yahoo.com/group/nosurgery4clubfoot/message/13223

Another post on relapses, including info from Global Health booklet:
http://health.groups.yahoo.com/group/nosurgery4clubfoot/message/20810

The Global Health booklet on clubfoot treatment. See page 26 for info on ATTT. There are even pictures showing the procedure being done:
http://www.global-help.org/publications/cf-english.pdf

I don't know if this helped or not, but wanted to respond.. I hope you are able to figure something out and get everything back on track.

Best wishes,

Teresa and Claire
age 4 1/2, left cf