| Ponseti Power Serial Casting |
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| Not all Serial Casting is PONSETI Serial Casting |
| Serial Casting is a term to describe casting that is done in a series of steps, usually over the course of a few weeks. The terms is not specific to the Ponseti Method - almost all forms of clubfoot correction involve the process of serial casting. So what sets the Ponseti Method of serial casting apart from other methods? A lot of very small yet very key details.
century ago that most doctors still fail to comprehend today is that the clubbed foot of an infant contains all the correct and necessary parts. Those parts are merely out of order, creating a very curable birth defect. Now liken that to a jig saw puzzle: If you cram all the parts together and glue them, you might get a general idea of the picture, but it won't be right. However, if you put the puzzle together in a methodical, sequential manner so all the joints fit exactly where they were meant to fit - then you end up with a beautiful masterpiece just like the manufacture intended. That's the secret to the Ponseti Method of serial casting: The sequence of events. Doctors who are trained in, and practice thoroughly the Ponseti Method of clubfoot correction, comprehend that the bones of the infant's foot must be put back in their correct position in a methodical and sequential manner. Part B will not be attempted until Part A has been perfected. Done in this A, B, C manner, the parts of the infant's foot slide back in to their normal anatomically correct position where they can then continue to grow in a very normal fashion in to normal adult feet. This sounds over simplified, but it is not. Put back in place in the proper sequential manner, the clubbed feet will lose their deformity and grow in to normal, healthy feet. Each phase of correction is achieved with serial casting: Moving part A, cast; move part B, cast; move part C, cast. Each week the bones of the clubbed foot are adjusted and casted so that in an average of five weeks, the foot is completely put back together normally. No cuts, no pins, no bones shortened or lengthened, no joints invaded.... it's just right back the way nature intended. By contrast, if a doctor merely places the feet in to a "normal looking position" (and yes, most do! Read about this in an article at the bottom of the Clubfoot Braces page.), then cast the foot there, then the next week cram it a little further and cast it again, several things are going to happen. The first and most obvious consequence will be the pain the infant will suffer. Having your bones crammed together into a abnormal position and held by a cast is of course a very painful procedure to undergo and your child is going to object to this pain loudly. (One of the leading indicators that a clubbed foot has been casted incorrectly is the baby's reaction to the pain! If your baby has been casted but continues to cry more than usual, or is inconsolable for no other apparent reason - you better assume his feet are being hurt! If you have to physically restrain your child during the casting procedure because he is strongly resisting the pain, then something is wrong! Proper casting is NOT a painful process!) Secondly, the bones of an infant are going to grow in to what ever position they are stuck in. Consider the old China women who had their feet bound into deformation during infancy in the name of vanity generations ago. If your doctor crams the bones in to what looks normal on the outside yet remains largely abnormal under the skin's surface, the bones are going to grow like that. Keep in mind that the bones of a foot do not all grow at the same rate; also, consider that an infant has more bones in his or her foot than an adult because as the child matures, some of these bones fuse together. If the bones are not where they belong, they are going to grow wrong, and fuse wrong. In time this will become an increased deformation rather than any measure of the initial clubfoot correction that you originally sought. The increased level of deformity in the bones is going to cause an increased level of pain that the doctor will then need to fix. How? With surgical intervention. Sounds simple enough but any time a bone is operated on, scar tissue is going to result over time. Scar tissue builds us and becomes a demon of its own design. To correct the issue of scar tissue causing pain, more surgery is performed. That surgery eventually has it's own scar tissue build up... It becomes a sequence of casts and operations and pain for the rest of that individual's life leading almost always to permanent disability that increases with age.
child through such an ordeal that will carry over in to that child's adult years and seriously decrease that child's quality of life forever? Ignorance, mostly. Remember ignorance, that highly curable disease? If you are reading this, you are taking steps towards curing your ignorance and I applaud your efforts! Why would a doctor use this method of correction when the non-surgical Ponseti Method has been available for more than fifty years? Money, perhaps, and ignorance, and arrogance.... The Ponseti Method is practically free compared to the traditional and outdated methods described here. Consider the range of 3 to 9 casts changed weekly (the average being five casts total) followed by a simple brace compared to several months of casting (six months worth in the case of my oldest son!) followed by bracing, physical therapy and surgeries. That is something like twenty-six office visits and casts you'd be paying for compared to five prior to the costs of surgery once those begin.
trained to intervene: to operate, complicate,interrogate,aggravate, associate, instigate and infiltrate until they find problems where none exist in the name of using all those fancy skills they learned in med school. Take child birth for a perfect example: Women have been bearing children since the dawn of time in caves and covered wagons and Ford trucks yet now days pregnancy is treated like a disease and pregnant women like lepers who need serious medical intervention to possibly survive the very act of birth God designed their body for. Much like clubfoot care, 95% of the births don't need serious medical intervention at all. The Ponseti Method is just so darn simple I believe it insults many doctors. A doctor who takes the time to train in, and practice, the Ponseti Method will find himself amazed at the difference, and yes indeed, a few doctors have seen the error in their ways, doing an about face in their treatments once they discovered the Method existed. Serial casting is not created equal. That is what you need to know as a parent. Done in the proper sequence, the Ponseti Method will correct the clubbed feet of an infant or toddler with out surgical intervention 95% of the time. Done wrong, serial casting will further deform the clubbed feet, doing much more harm than good, often resulting in Atypical feet that become highly resistant to any casting whatsoever (as in the case of my oldest son Brian). If your child's clubfeet progress to an Atypical condition, surgery becomes very likely. Dr. Ponseti's clinic in Iowa City, Iowa is making large strides in changing that. In recent years the doctors in his clinic have seen an increased level of success casting atypical feet back to normal with out surgery - so not all is lost.
it becomes absolutely paramount that you seek out a very highly skilled Ponseti Method doctor to have any hope whatsoever of avoiding surgical correction. Contact Dr. Ponseti's clinic immediately and hawk the house if you must to travel there! Even if surgery becomes necessary, there is a better alternative, called the ATTT, which is the surgery of choice in the Ponseti Method when surgery is the only alternative left. This is the surgery Brian had (shown to your left). Unlike most clubfoot surgeries, it is highly non-invasive. No bones are cut, no joints are taken apart, no muscles peeled away or pins inserted.... This is the process of taking one tendon loose and anchoring it in a new position to pull the foot around straight. The child wears a cast while this heals, about six weeks.
own ignorance as a new mother, for Brian to have gone through all this. I am to blame. blessing to do. Remember that - there is no one to really blame but yourself if you fail to learn something about the alternatives you have at your disposal. I cannot stress enough how strong you must be as a parent to ensure your child is getting the right treatment. I cannot stress enough that you have to locate a doctor that is right, rather than letting one be picked for you through default as we did with Brian. Your pediatrician is going to recommend someone. Your mother, your mother in law, your neighbor, your grocer - everyone is going to tell ya, "He's the best!" All the doctors are going to come "highly recommended." Our doctor who did this to Brian came to us highly recommended. Don't settle for a recommendation - settle for the cold hard facts you took the time to research and trust. What you have to say to the doctors in the delivery ward who try to whisk your child off to the casting room hours after his birth is, "No thank you!" They will try to guilt you in to it with things like, "He will be deformed if you don't start right now!" You smile, hold your baby to your breast and repeat, "No thank you, I have other treatment plans lined up to use the Ponseti Method." Most doctors won't know what that is and will resent a woman who suggests she might know more about treating this birth defect than he does. Many others will try to tell you the Ponseti Method is over rated and ineffective because they are uneducated about it. All will prey on your raging after-delivery hormones and new-mother emotions. Be strong! Daddy's in the group - you be strong too and refuse to let unqualified hands touch this child's feet! Again, smile and tell them No Thank you.
delivering your child at a hospital with a bona fide Ponseti Method doctor on staff whom you have already met, interviewed, checked personal references on and have found to be acceptable beyond any shadow of a doubt, do not let anyone at that hospital begin treatment on your child! Even one wrong cast can set proper treatment back significantly! Remember: You have time. Treatment does not have to begin with in the very first few days of life to be successful! Even if your child CAN be treated at the hospital of his or her birth, you still do not have to cast this child with in the first few days of his life. Go home! Enjoy your new born just as he was born, bond with him, let the family bond with him, let him get his strength up and his eating habits established, recovery from your delivery both physically and emotionally, allow that child to recover from his own birth and adjust to life outside the womb before you throw his young life in to a tail spin. If older siblings are involved, give them the opportunity to bond with the new baby and get over the initial feeling of being "put out" by the baby before the baby gains even more attention because of his deformity being treated. If you were surprised at birth by the clubfoot condition, that is OK. Take your child home just as God made him. Love him, adore him, photograph him, accept him - and start finding the Ponseti Method doctor of your choice to treat him. You have a couple weeks, even a month or two if absolutely necessary, before treatment needs to begin. Delay the right serial casting treatment, do not haste to start the wrong treatment! Given time to be done right, your child has a 95% chance of growing up with perfectly normal feet - feet that can be corrected before the child is old enough to ever know the difference. There really is Life After Clubfoot. Don't believe me? then look at my Soggy Bottom Boy's Six Feet Photo Gallery! Clubfoot only has to change your life for the better, but it is up to you. |
Brian - new born, bilateral clubfeet.
Brian wearing his very first set of
casts. They look normal enough -
how would an uneducated parent
know these would end up doing
him much more harm than good?
casts. They look normal enough -
how would an uneducated parent
know these would end up doing
him much more harm than good?
After six full months of casting,
you see Brian's feet are worse
now than they were at birth. This
photo shows a classic case of
"Atypical" clubfeet - which result
from improper serial casting
techniques applied by a "highly
recommended" Dr. B-- in Fort
Smith, Arkansas. I can only hope
he finds this site and is
enlightened to either learn The
Method, or quit clubfoot care
completely.
Dr. Ponseti has worked on
correcting many babies with
Atypical clubfeet, however, he
says he has never seen a baby
born with atypical clubfeet. They
are always caused by incompetent
serial casting at the hands of an
unskilled physician.
you see Brian's feet are worse
now than they were at birth. This
photo shows a classic case of
"Atypical" clubfeet - which result
from improper serial casting
techniques applied by a "highly
recommended" Dr. B-- in Fort
Smith, Arkansas. I can only hope
he finds this site and is
enlightened to either learn The
Method, or quit clubfoot care
completely.
Dr. Ponseti has worked on
correcting many babies with
Atypical clubfeet, however, he
says he has never seen a baby
born with atypical clubfeet. They
are always caused by incompetent
serial casting at the hands of an
unskilled physician.
At fourteen months of age (the age my
other two children started walking
normally despite being born with the
same birth defect), Brian is wearing
AFO braces which we know now do
nothing to help clubfeet; he was also in
physical therapy twice a week and
prescribed the use of this walking
device. Remember: Both his younger
brothers walked normally by this age
due to the Ponseti Method.
other two children started walking
normally despite being born with the
same birth defect), Brian is wearing
AFO braces which we know now do
nothing to help clubfeet; he was also in
physical therapy twice a week and
prescribed the use of this walking
device. Remember: Both his younger
brothers walked normally by this age
due to the Ponseti Method.
A month and five days past his 2nd
birthday, Brian went in to have the
ATTT surgery, spending the next six
weeks of the summer in heavy casts.
birthday, Brian went in to have the
ATTT surgery, spending the next six
weeks of the summer in heavy casts.
The series of photos above
show the process of removing
the post-op casts.
It's not a pleasant thing.
If your child ends up having
multiple surgeries to correct his
clubfoot, photos such as these
will begin to fill your scrap books.
show the process of removing
the post-op casts.
It's not a pleasant thing.
If your child ends up having
multiple surgeries to correct his
clubfoot, photos such as these
will begin to fill your scrap books.
Brian's feet at age 8 years old. Dr.
Ponseti predicts that by his teen
years, Brian will begin to suffer a lot
of pain in his feet that will carry
though his adulthood.
Ponseti predicts that by his teen
years, Brian will begin to suffer a lot
of pain in his feet that will carry
though his adulthood.
| Return to Ponseti Method of Orthopaedic Serial Casting Top of Page Serial Cast Removal at Home Return to six-feet.com Home Page |
| Garrison Alexander just moments old - born at home, clubbed feet and all :) [His big brother Everett was born in the truck seat parked along the highway...] |
The Ponseti Method of serial casting
requires a doctor to meticulously hold
the tiny bones in place as the foot is
casted in place. Here Dr. Ponseti is
holding Garrison's foot as the plaster
hardens.
requires a doctor to meticulously hold
the tiny bones in place as the foot is
casted in place. Here Dr. Ponseti is
holding Garrison's foot as the plaster
hardens.
Above: Brian holds Garrison
wearing his first set of serial
casts. Below, Everett colors
the same set of casts.
wearing his first set of serial
casts. Below, Everett colors
the same set of casts.
Having worn only two sets of
Ponseti serial casts, Garrison's
feet already look this good. The
third set of casts will be applied
here.
Ponseti serial casts, Garrison's
feet already look this good. The
third set of casts will be applied
here.
Garrison recieved his first set of
Ponseti serial casts on March 29th;
his 2nd set on April 3rd; his third
set of casts on April 7th; in the
photo above he is ready to get his
fourth and final set of Ponseti serial
casts on April 12th.
Notice the feet are over-corrected
as per the Ponseti Method.
Ponseti serial casts on March 29th;
his 2nd set on April 3rd; his third
set of casts on April 7th; in the
photo above he is ready to get his
fourth and final set of Ponseti serial
casts on April 12th.
Notice the feet are over-corrected
as per the Ponseti Method.
And here, April 13th, we are 700
miles back home to Oklahoma.
After sixteen days out of state
getting his little clubfeet fixed,
Granny June and Garrison have a
lot of catching up to do!
miles back home to Oklahoma.
After sixteen days out of state
getting his little clubfeet fixed,
Granny June and Garrison have a
lot of catching up to do!
Nine days later on April 21st, we took
Garrison's last set of "coming home" serial
casts off.
Start to finish, Garrison wore casts for only
TWENTY-FIVE days yet he got 100%
correction via the Ponseti Method! If your
child's treatment cannot compare with this -
please consider rushing to your nearest
Ponseti qualified doctor today!
Note: typically the last cast stays on the
baby for 14 to 21 days. Because Garrison
did not have a tenotomy (although his
brother Everett did), and he outgrew his
casts so fast, we had to remove them
earlier than normal.
Garrison's last set of "coming home" serial
casts off.
Start to finish, Garrison wore casts for only
TWENTY-FIVE days yet he got 100%
correction via the Ponseti Method! If your
child's treatment cannot compare with this -
please consider rushing to your nearest
Ponseti qualified doctor today!
Note: typically the last cast stays on the
baby for 14 to 21 days. Because Garrison
did not have a tenotomy (although his
brother Everett did), and he outgrew his
casts so fast, we had to remove them
earlier than normal.
2 year old Everett with Garrison.
As soon as the Ponseti serial casting
phase was over with, Garrison
moved right in to his clubfoot brace,
this one made by MD Orthopaedics,
known as the Mitchell AFO (FAB,
Sandals), just like his big brother
Everett.
phase was over with, Garrison
moved right in to his clubfoot brace,
this one made by MD Orthopaedics,
known as the Mitchell AFO (FAB,
Sandals), just like his big brother
Everett.
If you are the parent of a child with clubfoot that is currently being
treated by any method other than the Ponseti Method, or if you are
the parent of a child born with clubfoot who is currently looking for
the best method of treatment to start with - I want to urge you to
think seriously about what you've seen on this website.
Garrison's feet were fixed in ONLY TWENTY FIVE DAYS.
His brother Everett only took FORTY-TWO days! He had 5 casts
instead of four, plus a tenotomy, then wore his coming home casts
for a full 14 days, explaining the extra length of time he wore casts
compared to Garrison.
Brian, bless his heart, he wore casts more than nine months and
still ended up with less than satisfactory results....
treated by any method other than the Ponseti Method, or if you are
the parent of a child born with clubfoot who is currently looking for
the best method of treatment to start with - I want to urge you to
think seriously about what you've seen on this website.
Garrison's feet were fixed in ONLY TWENTY FIVE DAYS.
His brother Everett only took FORTY-TWO days! He had 5 casts
instead of four, plus a tenotomy, then wore his coming home casts
for a full 14 days, explaining the extra length of time he wore casts
compared to Garrison.
Brian, bless his heart, he wore casts more than nine months and
still ended up with less than satisfactory results....
| How To Remove Orthopaedic Casts from Infants and Children. |