Every child who does not get proper bracing ends up with a relapsed foot. Having learnt that long-term bracing is important to maintain the correction, it is the duty of responsible parents, sincere doctors and committed program managers to make sure the child is given a proper special shoe that keeps the foot in the corrected position.
The foot that is corrected using manipulation and casting has to be maintained for at least four to five years. Scientifically it has been proved that once the foot is maintained for five years there is very little or no chance of relapse.
Relapse is directly linked to compliance and cooperation of parents. Dr Ponseti and other senior doctors have over and again researched the need for a foot abduction brace and concluded that every child born with clubfoot and undergone the Ponseti method of treatment requires a minimum of four to five years of bracing. The foot has to be kept in an abducted position with dorsiflexion at night and during naptime. Neither the doctors nor the parents or the program managers or counsellors should try to test skipping of bracing in any child. The result of such testing is relapse and the child has to restart the treatment from the beginning; i.e. manipulation, casting, tenotomy and again bracing. There is no shortcut to maintain the correction, so please do not experiment or do any research on innocent children.
Availability and accessibility to braces are as important to maintain the correction as having trained doctors and casting materials for plaster casting. Please remember that the treatment begins with weekly casting and it concludes only after 5 years of bracing. The advantage is that after 3 months of 23 hours of bracing it is only night and naptime bracing. We insist that the child wear the brace both night and naptime so that it becomes a routine activity for parents and children to wear the brace and sleep.
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