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New Innovation in Clubfoot Treatment

llow recurrent clubfoot deformities that may require extensive surgery. In fact, past studies had shown that about 30 percent to 40 percent of families do not use the traditional brace as prescribed.

In contrast, the new brace has a soft, custom-molded interface that is placed inside of a solid ankle-foot orthosis, an orthopedic appliance designed to maintain alignment of the bones in the foot and ankle.

The bar connecting the feet has a release mechanism that allows parents to easily detach and reattach the bar to place the child in a car seat or high chair or change a diaper without removing the entire brace. Other differences from the traditional brace is that the Dobbs brace also allows children to move their legs independently while wearing the brace.

Dobbs said these changes are key to preventing a recurrence of clubfoot. "While we've had good success in obtaining correction in clubfeet, maintaining that correction has been more challenging," Dobbs said. "If the child is tolerating the brace well, there is a higher likelihood of parental compliance."

All 28 patients in the study had reached full correction for their clubfoot before being fitted for the brace. Eighteen patients who had not been wearing the traditional brace as prescribed were fitted for the Dobbs brace. The remaining patients were fitted only for the Dobbs brace. All but two patients wore the brace as prescribed.

Of the two patients who were noncompliant in wearing the brace, one patient had skin blistering due to improper use of the brace, which was eventually corrected, while the other patient was not kept in the brace because of the caregiver's work schedule.

"The newly designed, more flexible foot abduction orthosis is equally effective, or more so, than the traditional brace, considering rates of clubfoot relapse were less with the new orthosis than those reported in several series using the traditional bra
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