Ponseti Clubfoot Clinic
Managing Relapse
Most common cause is non-compliance with bracing protocol
Recast as soon as relapse is identified to achieve 30 DF and 60 ER then continue bracing
Equinus relapse
- serial cast to get the foot DF > 15 degrees
- if this fails, repeat tenotomy < 2yo then 3 - 4 weeks in post-op cast
- open achilles lengthening for older children (rarely required)
Varus relapse
the ankle starts to roll out and your child will be walking on the outside of their affected foot/feet
- more common than equinus
- cast then continue bracing
Dynamic Supination
This is common and in 50% of cases that have fully flexible feet (i.e. no structural deformity) your childs foot while walking will still pull in and turn up (i.e. dynamic supination) due to muscle imbalance around the ankle.
Your surgeon can improve this imbalance by doing a tibialis anterior tendon transfer, which can be performed between 2 - 4 yrs of age.
This document was updated on Tuesday, 19th September 2006.
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