| Cuboid Bones and Clubfoot Relapse |
- Apparently, the cuboid bones can have a direct link to
clubfoot relapse, particularly in an atypical case.
Christina, whose son is featured on the Atypical Clubfoot page of Six-Feet.
com emailed me recently to update me on current events taking place with
her son's clubfoot treatment.
Hi Shawnee,
I've been MIA for awhile and I wanted to touch base and tell you what's been
going on with Alexander's treatment... After Dr. Ponseti applied 4 casts to
Alexander's foot, we removed his cast and put him into the brace on October 20,
2007. Within days he was pulling out of the cast and his foot was relapsing.
By the time we got back to Iowa on the 29th, we could barely keep the shoes on
him. Another cast was applied which we removed on November 10th. Once
again the clubfoot started to relapse and we were back in Iowa on the 30th of
November.
Dr. Ponseti x-rayed his foot at that time and found that his "cuboid bone"
was out of place and it kept pushing all the bones back after they were
corrected - causing the clubfoot relapse to occur.
Sooo, he was casted 3 more times to put the cuboid bone into a better place and
had a 2nd tenotomy just before Christmas. We removed the tenotomy cast and
put him into the Mitchell brace on January 4th and his feet look great so far (one
month later)!
The shoes fit like a glove and no sign of regression so far. We go back to Iowa
next week for a follow-up. Dr Ponseti was unable to get the cuboid bone to
exactly where it should be in our case - it is just in a better place that shouldn't
affect the other bones and in time as he grows, it should settle back to where it
should be.
Dr Ponseti said that a misplaced cuboid bone is very rare...about 1 in
1000. [This is the rate for clubfoot to occur, also] Oddly enough, there were 2
other families at the Ronald McDonald House with me at the same time with
cuboid bone issues. Same story as us...atypical clubfoot not diagnosed,
repeated relapses, go to see Dr Ponseti who found misplaced cuboid
bone... One family had a 5 month old who was at the same stage of treatment as
Alexander and the other had a 14 month old who had been in the brace for some
time and doing well.
Dr. Ponseti said that a cuboid bone could be misplaced from birth but that it is
also possible that mis-diagnosis of atypical clubfoot and mis-treatment
could also cause the bone to be pushed out of place... So we now have
another chapter to the clubfoot story - a misplaced cuboid bone that will
repeatedly push the rest of the bones in the corrected foot out of alignment.
Christina
- Parents who are finding their child keeps suffering a
relapse of the clubfoot condition would be well advised to
have their doctor look for a potential cuboid bone
misalignment to solve the problem. In the case of
Christina's son, and two other families she met personally,
the cuboid bone was corrected non-surgically, using only
serial casting, allowing the clubfoot to be corrected, and
remain corrected.
cuboid bones corrected, but I am just as sure there are even more children who
have had a clubfoot surgery to fix a foot that kept relapsing - with out the cuboid
bone being considered as the culprit.
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