One of the most common operative procedures is
a 'soft tissue release', carried out to
correct the short tendons and ligaments which
pull the foot out of position. It involves
lengthening the Achilles tendon, as well as
any other involved ligaments.
usual routine is to then plaster the foot
for 2 weeks, but only in a semi-corrected
position. This allows the wound to heal, without
putting stress on the stitches. After 2 weeks
the stitches are removed, and the foot is
once again put in plaster - this time in a
fully corrected position.
plaster is usually kept on for around 6 weeks,
after which time the foot is reviewed. If
the foot is not fully corrected, the plaster
may be reapplied, or a splint may be used.
timing of the surgery will vary, according
to your surgeon. Some will operate on very
young babies, but most surgeons feel that
this is not very effective, and that there
is also a risk of 'over-correcting'.
majority seem to like to operate at around
9 months, with the belief that when the casts
come off the child should be ready to start
walking on the foot, and this can help maintain
the correction. However, there are some surgeons
that feel that surgery should be carried out
as late as possible.
The Surgery Debate
Since the Ponseti Method has gained
popularity, many question the need for surgery
at all. However, the number of doctors
practicing here in the UK is still low.
Although many are willing to travel for
treatment, for some it is too difficult. In
addition, it has to followed exactly, and is a
long term treatment.
There are concerns amongst parents that
surgical treatment may cause further problems.
My experience with Bethany, however, has been
positive so far.
There are now many sites available with
details and personal experiences. My advice
would be to research these, and to discuss
with your doctor. Support is available no
matter which form of treatment you decide on,
and it can be a help.. so use it! :-)