Because mainstream medicine does not yet have a
    mainstream method of correcting clubfoot, there are a
    variety of braces on the market being used.   

    Many are counter-productive.   

    Parents need to educate themselves about the styles of
    clubfoot braces available so they may have intelligent
    conversations with their doctor, and so they will know not
    only that they do have choice, but what their choices are.

    Smart choices lead to corrected clubfeet.

The Mitchell FAB

Shown here is the Mitchell FAB which goes by  many common names
such as:

  •    The Ponseti Brace
  •    The PM (Ponseti / Mitchell) FAB
  •    John Mitchell's Shoes,
  •     Mitchell AFO or DBB
  •    Etc.

    Made of soft suede leather and form fitting rubber inner materials, this
    shoe has in the past two years become the standard for all other
    FAB's to live up to.

    I have used the (non-Mitchell!) AFO pictured further below, the
    Markell and the Mitchell shoes in the course of the past 9 years and
    only recommend the  Mitchell. Tips for Wearing this Brace, Here.


Read the MD Orthopaecis story here.


Manufacturer's Description: The device is used for the maintenance of
correction after castings or surgery for clubfoot, by controlling forefoot
adductovarus, hindfoot varus, and ankle equinus. The TEV-CRB series
should be used. The upper component is optional, depending on the
severity of the residual ITT.

Shawnee's Note:  Although designed to hold the foot in the
proper alignment, notice this brace prevents the child from
having normal knee function - it is more like a cast than the Foot
Abduction Brace which allows the child to move his/her legs,
maintaining and gaining muscle development.
AFO, KAFO, or DAFO or Any Variety of
This Bracing Style

Under ordinary conditions, the AFO (such as
pictured left or any variety of this)  has little or no
place in clubfoot correction as they can hold
neither the dorsiflexion nor the rotation of the foot
to prevent a relapsed condition.  In very rare
events, an AFO may be prescribed to use on  
your Ponseti Method child, but in almost ever
case, this happens in situations where the child
was treated surgically prior to any attempt at a
Ponseti Method treatment, and the child suffers
many ill effects from that previous treatment.  Do
not confuse this style of AFO with the Mitchell
AFO!
    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.
                                                                       
                                                                                    The Markell Clubfoot Brace

    The Markell has been around for decades and was once the
    norm in clubfoot correction via the Ponseti Method.  However,
    recent advances in the Mitchell FAB (mentioned above) have
    lessened it's popularity.  Many (most) children will still enjoy a
    complete corrective process using the Markell FAB, however,
    if your child sufferers the common ill affects of this system
    (blisters, pressure sores, etc.) then the Mitchell FAB is an
    excellent alternative to consider.
Everett, age 2, and
Garrison, age 9 weeks wear
their fancy matching
Mitchell FAB's.
Applying the Mitchell FAB to
Garrison, thumbnail photos
below, click to enlarge.
Baby Garrison isn't sure if he wants held by a 2 year old brother!
This photo was taken the day Garrison's last
casts came off.  He was immediately placed in
to his tiny little Mitchell FAB and appears not to
mind at all.
Clubfoot Braces

Return to  Six-Feet.com

Go to FAB wearing tips
Photos courtesy of Brian Adams.
Clubfoot Braces
Know Your F.A.B.
Foot Abduction Braces
and other styles of FAB's / DBB's/AFO's
When Children Say "NO!" to
Wearing Their Foot Abduction
Brace.
and other Parental-Non-Compliance
Issues That Lead to a Relapse of the
Clubfoot Condition in a Child.
A Parent's Guide To The
Foot Abduction Brace
Everything You Need to Know About
Using the FAB Right Here!

By Kori Rush and Naomi Powell
Return to Clubfoot Braces Top of Page

Return to Six-Feet.com Home Page
Typically speaking, children

"should wear the brace 23
hours a day for 2 ½ to 3
months and then go to 20
hours a day for a month,
then 18 hours a day for a
month, then 16  hours a
day."

I.V. Ponseti, M.D.
    The Dobbs Dynamic Clubfoot Brace

    Also known as the Dobbs Articulating Bar, this foot abduction
    brace designed by Dr. Dobbs in St. Louis Missouri allows the
    child's legs to move independently yet still holds the outward
    rotation and dorsiflexion necessary to maintain correction of
    the clubfoot via the Ponseti Method.

    This bar can fit to the special AFO it was designed with, or it
    can fit on to the Markell shoe.  Soon the bar will be available
    with the Mitchell clubfoot shoes as well.
The Horton Click Bar for Clubfoot Bracing


The Horton click is a foot rotation bar that allows the feet to be
internally or externally rotated.  The Horton Click allows you to put
the shoes on the child with the bar removed, then "click" the bar
on afterwards.  With just a click you can easily remove the bar
from the shoes, change the child, and click the shoes back on the
bar.  The Horton Click is an excellent choice for kids going
through the Ponseti protocol for clubfoot treatment.  It is
commonly used with the Markell style of show but also with the
larger sizes of the Mitchell clubfoot shoes as well.
Please visit my page FAB Wearing Tips to learn more
about how to make wearing the clubfoot braces a
success for your child.
The Mitchell Articulating Bar

Made by MD Orthopaedics, the new articulating bar offers the
same advantages of the Dobbs Dynamic Bar mentioned above,
snapping easily in place of the traditional straight / flat bar you
may already have on your Mitchell FAB. Since the  
Ponseti-Mitchell shoe is recommended for atypical clubfeet,
this is currently the only articulating alternative for atypical
children.