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OUR LADY’S HOSPITAL FOR SICK CHILDREN, CRUMLIN, DUBLIN 12. THE PONSETI TECHNIQUE : INSTRUCTIONS FOR WEARING MARKELL BOOTS AND BAR CONTENTS TOPIC PAGE(S) Why are boots and bar important? How long will my child wear the boots and bar? Will my child need any other special equipment? Who can fit the boots and bars? Will
my child be comfortable in the boots? You must contact the hospital if:
When the plaster is removed your baby’s feet and legs may look quite swollen. This will start to settle down once the plaster has been off for a few days.
The boots and bar are to be worn twenty-three hours per day for approximately three months. They can only be removed for bathing and dressing (an hour maximum). After three months the boots can be worn for sleeping and napping only. Well fitting shoes must be worn for all other times. This is usually up to the age of four to five years.
No, your child can use their pram, car seat or high chair as before, as long as the strap between the legs is detachable it can be threaded between the bar and legs. If your child is wearing trousers they will need to have poppers or buttons between the legs. A sleeping bag/night suit to accommodate the bar and boots can be ordered via internet site www.grobag.co.uk.
A member of the team does the first fitting. You will then be taught how to fit them yourself, so that the boots can be fitted at home. The boots are set at the correct angle, which must not be altered by anyone other than a member of the team. The most difficult foot is fitted first i.e. the affected side, where both feet are affected fit the least flexible foot first. Usually one foot is more moveable than the other. This is fitted last. Boots can be worn with or without socks. It is most important to make sure the heel is placed at the very back of the boot and held firmly in place by the tongue and heel-retaining strap. Once the heel is in place the laces can be fastened and the other boot can be fitted in the same way. If the toes move back this usually means that the heel is not flat in the boot.
Your child will probably be upset when they first have the boots fitted. This is not because they are in pain. It is because it is frustrating to your child to have both feet joined together in the bar. You can help your child through play by doing exercises that teach your child to bend both knees at the same time. Your child will soon learn to move both feet together. The more time that your child spends wearing the boots the sooner they will get used to moving both legs together. If you notice your child is crying more than usual, check boots are fitted correctly and check for rubbing or blisters. These may indicate that boots are getting small or the bar needs lengthening and if blisters occur your child will need to be seen in clinic.
Usually your child will return one week after the first fitting, then after six more weeks and finally after three months. Your child will then be seen every three to six months. You must contact the hospital if: You
have difficulty fitting the boots yourself IF YOU DO NOT FOLLOW ALL OF THE INSTRUCTIONS THE TREATMENT IS LIKELY TO BE UNSUCCESSFUL.
Olga Gallagher / Catherine Howells – and ask for bleep 8336 or phone (01) 4096100 ext: 2377. Eimear Walsh / Eavan Guilfoyle – physiotherapy department (01) 4096551 After hours/weekends Orthopaedic registrar on call – contact through main hospital switch. (01) 409 6100
Instructions
for wearing boots and bars | ||||||||||||||||||
