| MD Orthopaedics Design and Manufacture of the Only Clubfoot Brace Endorsed by Dr. Ponseti |
MD Orthopaedics, founded and owned by John Mitchell, a Wayland
Iowa based designer of medical instruments and models,
established MD Orthopaedics in 2003 for the purpose of providing
an effective, patient friendly device to assist in the treatment of
clubfoot. This device is a significant component of the "Ponseti
Method" which has become the most popular and effective
alternative to orthopaedic surgery.
The Mitchell brace is referred to by many different names: Mitchell
shoes, Mitchell AFO, Ponseti-Mitchell Brace, Mitchell FAB, P-M
brace, Mitchell clubfoot shoes, foot abduction brace, FAB, DBB,
boots on a bar, sandals, Ponseti brace, clubfoot shoes, orthoses,
and more.
Despite any confusion of terms, all refer to the device designed
and manufactured by MD Orthopaedics in conjunction with Dr.
Ignacio V. Ponseti, the most renowned and respected orthopaedic
surgeon worldwide with his method and practices well published.
MD Orthopaedics goes beyond the manufacture of a clubfoot brace,
however. Superior customer service has helped parents world-wide
continue their child's clubfoot treatment by providing what parents
need, when parents need it, including custom built pediatric
orthotics for children with such conditions as Atypical clubfeet that
do not respond well to normal bracing methods.
The John Mitchell FAB is currently the only foot abduction
brace I recommend for the continued treatment of clubfoot
following the Ponseti Method of serial casting treatment.
While the market continues to grow (finally after decades of no
changes nor improvements to the idea),currently other new models
are still under the microscope. Of those new clubfoot bracing
systems that have seen success, most actually implement the
Mitchell shoe because it gives such superior comfort to the child.
Starting in 2003 when Everett was just a few months old, we began
using one of the very first Mitchell FAB prototypes in effort to find a
FAB that would not hurt his feet. Since then Everett has worn
several pair of the Mitchell braces, and when Garrison came along
and also needed clubfoot care, the Ponseti-Mitchell FAB was our
first and obvious choice.
likely to actually use the brace as prescribed by the Ponseti
Protocol for wear to ensure full correction.
By using your FAB as prescribed, your child has a better than
normal, in fact, he or she has an excellent chance, of living a
normal, healthy life. My clubfoot photos page can prove it.
Iowa based designer of medical instruments and models,
established MD Orthopaedics in 2003 for the purpose of providing
an effective, patient friendly device to assist in the treatment of
clubfoot. This device is a significant component of the "Ponseti
Method" which has become the most popular and effective
alternative to orthopaedic surgery.
The Mitchell brace is referred to by many different names: Mitchell
shoes, Mitchell AFO, Ponseti-Mitchell Brace, Mitchell FAB, P-M
brace, Mitchell clubfoot shoes, foot abduction brace, FAB, DBB,
boots on a bar, sandals, Ponseti brace, clubfoot shoes, orthoses,
and more.
Despite any confusion of terms, all refer to the device designed
and manufactured by MD Orthopaedics in conjunction with Dr.
Ignacio V. Ponseti, the most renowned and respected orthopaedic
surgeon worldwide with his method and practices well published.
MD Orthopaedics goes beyond the manufacture of a clubfoot brace,
however. Superior customer service has helped parents world-wide
continue their child's clubfoot treatment by providing what parents
need, when parents need it, including custom built pediatric
orthotics for children with such conditions as Atypical clubfeet that
do not respond well to normal bracing methods.
The John Mitchell FAB is currently the only foot abduction
brace I recommend for the continued treatment of clubfoot
following the Ponseti Method of serial casting treatment.
While the market continues to grow (finally after decades of no
changes nor improvements to the idea),currently other new models
are still under the microscope. Of those new clubfoot bracing
systems that have seen success, most actually implement the
Mitchell shoe because it gives such superior comfort to the child.
Starting in 2003 when Everett was just a few months old, we began
using one of the very first Mitchell FAB prototypes in effort to find a
FAB that would not hurt his feet. Since then Everett has worn
several pair of the Mitchell braces, and when Garrison came along
and also needed clubfoot care, the Ponseti-Mitchell FAB was our
first and obvious choice.
- Both boys have enjoyed excellent clubfoot
correction by using the Ponseti Method
followed by use of the MD Orthopaedics
foot abduction brace - or "shoes on a
bar". Both boys have also tested out
several other new Mitchell designs over
the years as John's company continues to
advance the quality of their product.
What parents will find using the Mitchell
FAB is that the brace is a system that has
proven it works while still offering children
light weight wear compared to the other
styles available(seen at Clubfoot Braces)
But more importantly is how easy this foot
abduction brace is to use.
Attaching with only three straps and simple
buckles, applying this FAB to your child is
a cinch, as easy as putting on any other
little pair of sandals the child might wear
for recreation.
likely to actually use the brace as prescribed by the Ponseti
Protocol for wear to ensure full correction.
By using your FAB as prescribed, your child has a better than
normal, in fact, he or she has an excellent chance, of living a
normal, healthy life. My clubfoot photos page can prove it.
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| This photo shows Everett in the Markell clubfoot brace he wore briefly before we were given the opportunity to try the Mitchell FAB prototype in 2003. |
| Just past his 3rd birthday, Everett continues to wear his Mitchell clubfoot brace. This photo demonstrates how the new "click-bar" allowed us to use the fuzzy feet built in to his pajamas instead of cutting them off like we had to do previously. |
| Here is baby Garrison, his first day in his first Mitchell Clubfoot Brace. |
Clubfoot Brace Wear You should aways check with your doctor before you reduce the hours your child in his or her brace, however, here is a general rule of thumb offered by Dr. Ponseti: "After 3 months of full time brace wear, we usually gradually wean the babies out of the brace. We try to have the babies wear the brace at night and nap time for a total of 16-18 hours and once they are walking wear it at least 14 hours. We used to recommend bracing continue to age 3, but since we have seen some relapses, we now recommend 3 1/2 to 4 years of age. I.V. Ponseti, M.D." The total hours is the key - you can skip applying the brace at nap time if your total hours can be achieved in one long stretch over night, which is the way I recommend you use it. Splitting the hours up between naps and bed time often leads to a accidental reduction of hours as you become side tracked, or the baby is having so much playing you don't want to put the brace back on, or you merely forget, losing track of the time. I suggest you pick a schedule of total-hours and stick to it, for example, the brace goes on at 7 PM in the evening and does not come off until the total number of hours later, which will be at some specific time the next morning. |
| 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. |
Children's games, sports, camping, fishing, baseball, family
vacations and daily activity will be a happy part of your lives as the
deformity your baby was born with melts away before your eyes.
A lot of doctors have said their patients to not adhere to FAB
usage. This is due largely to the fact that previous models of foot
abduction braces have been difficult to put on, heavy to wear (or
carry a child in) and uncomfortable to the child who has to wear
them. Pressure sores and blisters were also a common side effect.
The clubfoot brace designed by MD Orthopaedics
understood those issues, and has eliminated them. Their
clubfoot shoe is light, soft, and most important to the baby:
comfortable. A child can easily roll over, sit up, lay down, crawl,
cruise and yes, even walk wearing their Mitchell clubfoot brace.
Everett even jumps in his, and other children have been seen
dancing and running!
The cute, leather sandal design of this foot abduction brace
combined with the non-obtrusive light weight bar also makes it seem
less like a "medical device" - another reason parents are more likely
to adhere to using it when they might otherwise quit bracing earlier
than prescribed... it doesn't scream "Birth Defect In Action!" to
passers by who see the child wearing it.
Hardly sounds terrible, does it? No, because it isn't. Since
children can enjoy just about all their activities while wearing
the brace, they complain about it a lot less, thus they wear it
a lot more, and are much more likely to wear the brace until
the end of their correction phase, around the age of four or
five years.
I know wearing a brace until that age sounds impossible, terrible,
and to be blunt - it sounds like a total pain in the butt. I thought
so to when I first began the Ponseti Method. Compared to the
surgical alternative though, it's a walk in the park on a clear, sunny
day.
In the beginning, the baby wears the brace for 23 hours a day for a
few months. Most babies are unaware of situation and quickly
learn, with your help, to kick their feet and do their normal things.
Most parents even discover that wearing the bar makes diaper
changes a lot easier! The baby has a built in handle for lifting the
legs :)
Then the time of wear begins to decline, from 23 hours, down to 20,
to 18, 16, 14, and finally to 12 hours a night. During this time your
baby will learn how to roll over, sit up, scoot, slither, crawl.
FAB wear does not delay developmental milestones at all! Some
even claim it can enhance development because the bar serves to
act as a tripod, helping some children learn to sit up earlier than
they might other wise.
vacations and daily activity will be a happy part of your lives as the
deformity your baby was born with melts away before your eyes.
- The Ponseti Method boasts a 95% success
rate. Dr. Ponseti tells me he only does
20% of the work with his serial casting.
"The parent does the other 80% by using
the brace (according to the hours
prescribed)."
A lot of doctors have said their patients to not adhere to FAB
usage. This is due largely to the fact that previous models of foot
abduction braces have been difficult to put on, heavy to wear (or
carry a child in) and uncomfortable to the child who has to wear
them. Pressure sores and blisters were also a common side effect.
The clubfoot brace designed by MD Orthopaedics
understood those issues, and has eliminated them. Their
clubfoot shoe is light, soft, and most important to the baby:
comfortable. A child can easily roll over, sit up, lay down, crawl,
cruise and yes, even walk wearing their Mitchell clubfoot brace.
Everett even jumps in his, and other children have been seen
dancing and running!
The cute, leather sandal design of this foot abduction brace
combined with the non-obtrusive light weight bar also makes it seem
less like a "medical device" - another reason parents are more likely
to adhere to using it when they might otherwise quit bracing earlier
than prescribed... it doesn't scream "Birth Defect In Action!" to
passers by who see the child wearing it.
Hardly sounds terrible, does it? No, because it isn't. Since
children can enjoy just about all their activities while wearing
the brace, they complain about it a lot less, thus they wear it
a lot more, and are much more likely to wear the brace until
the end of their correction phase, around the age of four or
five years.
I know wearing a brace until that age sounds impossible, terrible,
and to be blunt - it sounds like a total pain in the butt. I thought
so to when I first began the Ponseti Method. Compared to the
surgical alternative though, it's a walk in the park on a clear, sunny
day.
In the beginning, the baby wears the brace for 23 hours a day for a
few months. Most babies are unaware of situation and quickly
learn, with your help, to kick their feet and do their normal things.
Most parents even discover that wearing the bar makes diaper
changes a lot easier! The baby has a built in handle for lifting the
legs :)
Then the time of wear begins to decline, from 23 hours, down to 20,
to 18, 16, 14, and finally to 12 hours a night. During this time your
baby will learn how to roll over, sit up, scoot, slither, crawl.
- Understand that if your baby went through
the Ponseti Treatment and straight in to his
or her brace, this is all the child knows, so
it is their "Normal". They do what they
think they can do, not knowing that the
brace on their feet is in any way an
unusual piece of hardware attached to their
body.
FAB wear does not delay developmental milestones at all! Some
even claim it can enhance development because the bar serves to
act as a tripod, helping some children learn to sit up earlier than
they might other wise.
Only 7 weeks
old, baby
Garrison sits in
camp with us
at a state park
in Oklahoma.
We just bring
the FAB's with
us and use
them while on
vacation as we
would at home.
old, baby
Garrison sits in
camp with us
at a state park
in Oklahoma.
We just bring
the FAB's with
us and use
them while on
vacation as we
would at home.
| Everett inspires the designers at MD Orthopaedics to build child-tough clubfoot braces that hold up to the rigors of children's games! In the photo below, the arrow points to this same photo hanging over the designer's work bench. |
| A short family vacation at Cedar Key, Florida. Garrison, Everett and Brian are happy customers of Dr. Ponseti as their birth defect is no longer a part of their life. Although Brian did not use the Mitchell FAB and did not begin his treatment with the Ponseti Method, Everett and Garrison did, and now enjoy a 100% level of correction. |
| Shown in this photo, Garrison is 15 months old and has been walking independently for a month. At this age he is wearing his Mitchell clubfoot brace for 14 to 16 hours a day. He is already attempting to walk while wearing the brace, as well. Notice how normal his feet look. |
| The six previously clubbed feet of my three sons, left to right, Garrison (15 months), Brian (9 years) and Everett (3 years). While Brian's feet still show the tell-tale signs of the inferior treatment he received for two years prior to our discovery of Dr. Ponseti, the two younger boy's feet look completely normal - as they should after using the Ponseti Method followed by strict adherence to the Mitchell orthotic brace on their feet. |
By your child's first birthday, you can expect to
be in the FAB approximately sixteen hours a
day. This will be covered mostly at night while
the baby is asleep, with a few additional hours.
By your child's second birthday however, you
will likely be down to wearing the FAB only
twelve hours, which is definitely only night time
wear since the typical child requires at least
eleven hours of sleep a night. The FAB simply
becomes part of the child's bedtime
routine, like an extension of their pajamas.
In cold climates, the new Snap-On / Snap-Off
bar on the Mitchell shoes allows you to use
footie pajamas on your baby. Simply snip a
small slit in the heel area of the pajama leg
where the bar can slide through and snap to the
shoe.
It is true, the Mitchell foot abduction brace used
in the Ponseti Method of clubfoot treatment
does cost more than the standard FAB, but you
will find it is worth every penny spent. Even
then, the cost is not out of reach. If your baby is
currently wearing the white boots connected to
a heavy, bulky bar, you should contact MD
Orthopaedics regarding replacing it with a
Mitchell clubfoot brace. You and your baby will
both be a lot happier, and you will both tolerate
the hours of wear much easier..... helping
ensure a future of outdoor fun.
be in the FAB approximately sixteen hours a
day. This will be covered mostly at night while
the baby is asleep, with a few additional hours.
By your child's second birthday however, you
will likely be down to wearing the FAB only
twelve hours, which is definitely only night time
wear since the typical child requires at least
eleven hours of sleep a night. The FAB simply
becomes part of the child's bedtime
routine, like an extension of their pajamas.
In cold climates, the new Snap-On / Snap-Off
bar on the Mitchell shoes allows you to use
footie pajamas on your baby. Simply snip a
small slit in the heel area of the pajama leg
where the bar can slide through and snap to the
shoe.
It is true, the Mitchell foot abduction brace used
in the Ponseti Method of clubfoot treatment
does cost more than the standard FAB, but you
will find it is worth every penny spent. Even
then, the cost is not out of reach. If your baby is
currently wearing the white boots connected to
a heavy, bulky bar, you should contact MD
Orthopaedics regarding replacing it with a
Mitchell clubfoot brace. You and your baby will
both be a lot happier, and you will both tolerate
the hours of wear much easier..... helping
ensure a future of outdoor fun.
| Brian and Everett sitting on one of the big old trees Cedar Key is named for with the wide blue ocean behind them. Outdoor sports and recreation continue to be the big part of our life despite three sons born with what could have been a permanently disabling birth defect. |
| Read this inspiring article about how John Mitchell got started in building the Ponseti Clubfoot Brace. Walking With Faith. |
| MD Orthopaedics Official Website MD Orthopaedics @ six-feet.com Clubfoot Braces Orthopaedic Cast Removal (a necessary step before you start using a brace) FAB Wearing Tips Six-Feet.com |
| Shawnee (yours truly) holding baby Garrison, Brian beside me, and Everett standing in front at the MD Orthopaedics plant in Iowa. March 2007, returning to see Dr. Ponseti for the boy's annual check up. |
| Did you ever wonder what happens to all those little plaster molds of your child's feet? Well, here they are, archived and saved at John's shop. (Kind of creepy, actually) |
| Like a well-oiled machine, from the plaster molds through the construction process, each pair is hand made and shipped throughout the world (the pins on the map above show locations where these FAB's have been sent) |
| John's "Right Hand Man" is Emily. She and Everett became instant buds. |
| Thumbnail photos, click to enlarge |
| Garrison's 1st birthday, above |
| C-Pro Direct European agents for Mitchell Designs, USA. Orders for Italy, please contact www.centroessedi.it Tel : 0331 502909 |
| The new Mitchell Articulating Bar is Here! |