Foot Abduction Brace

It is worth repeating this statement, a foot abduction brace is given to a fully corrected foot (normal foot) and not clubfoot (deformed foot). A half-corrected or uncorrected foot cannot be corrected with the help of a foot abduction brace. Manipulation and weekly plaster casting get over in an average of four to six weeks, but bracing has to be continued for another at least 250 weeks! In the treatment for clubfoot every step i.e. manipulation, casting, and bracing are all very important and nothing can be ignored or considered insignificant.

Also, remember that children do cry for the first two to three days when the brace is worn.

• Allow the child to play with the brace even during the casting period to get familiarised for a few days before the child is asked to wear it.
• It is important that the parents do not remove the brace in response to the child’s fussing or mild crying.
• It is very important to know that the foot abduction brace has to be tied tight ensuring to avoid friction between the skin and the leather. The brace should not be tied so loosely that the purpose of keeping the foot in the corrected position fails nor tied too tight that the foot starts swelling.
• Always remember to have patience while putting on the brace. Never give any feeling to the child that it is unnatural that the child has to wear a brace.
• Never use the brace to threaten the child; (“If you don’t eat food, I will put brace now!) Such statements create negativity among children towards brace.

Choosing the right foot abduction brace and using it as per the protocol is the key to the successful conclusion of clubfoot treatment. The doctor could be very good, the casting is given maybe the best as possible, tenotomy was done and all went well and the foot was corrected.

But if the brace is not used well, the foot will come back to the original clubfoot position.

To bring any change again in the foot, the same manipulation and casting treatment has to be initiated including tenotomy. And remember, this time the child has grown big and casting could be very uneasy for the older child and difficult for him/her to carry out daily activities. It is always better to treat the child very young and complete the bracing protocol before the child is five years old.

Protocol for bracing is that the child should be given bracing 23 hours a day for the first three months and for the next five years the brace has to be worn at night and during naptime. Remember there is no alternative to bracing but:

patience from parents and close follow-up from doctors and counsellors.

These are very important during the long-term bracing follow-up.