Foot abduction orthotics is used after clubfoot has been corrected by casting, manipulation, and surgery. The orthosis or brace is two open-toed leather boots connected by a metal bar. The brace maintains the corrected position of the feet. The orthotics has an adjustable aluminum bar and footplates. A specially trained person called an Orthotist will make, fit and set up the footplates. The shoes have buckles inside so you can tighten the strap and laces without turning your child over.
The orthotics is used once the last set of casts is removed. Your child wears the orthotics for 23 hours a day for the first three months (may be removed for baths). For the next 3-4 years, the orthotics is used at night and naptime only. Your doctor will decide how long your child will wear the orthotics. Do not end treatment early.
- Always use cotton socks that cover the foot everywhere the shoe touches the child’s foot and leg. Use two pairs of socks for the first two days of orthotic use if your child’s skin is sensitive.
- Hold the foot into the shoe and tighten the middle strap first. The strap helps keep the heel firmly down into the shoe and is the most important part of the orthotic.
- Check that your child’s heel is down in the shoe.
- Buckle the shoes tightly, but be careful not to cut off circulation.
- Be sure all of your child’s toes are straight and not curled under. To make certain of this, you may want to cut the toes out of a pair of socks so you can see the toes.
Set-up of Orthotic
The orthotic will be set-up by your orthotist, but you may need to change shoes and widen the bar as your child grows. Change the shoes only when your child’s toes can completely curl over the edge of the shoe.
- As your child gets used to the orthotics, your child may be fussy. This is because the orthotic is new and different, not because it is painful.
- Play with your child in the orthotic—it will help them get used to it. Teach your child to kick and swing the legs at the same time to move. You can do this by gently pushing and pulling on the bar of the orthotic to move the knees.
- Make wearing the orthotic routine. During the years that your child wears the orthotic only at nighttime and naptime, put on the orthotic as part of the bedtime routine.
- Pad the bar—a bicycle hand bar pad works well. By padding the bar you will protect your child, yourself, and your furniture from being hit by the bar when the orthotic is worn.
- Never use lotion on red spots on the skin. Some redness is normal with use. Bright red spots or blisters (especially on the back of the heel) mean that the shoe was not put on correctly. Contact your doctor if this happens.
- If your child keeps slipping out of the orthotic, try tightening the strap by one more hole.
- Tighten the screws on the bar on occasion. Tools will be given to you.