Dynamic abduction brace for Clubfoot
Abdul Razak Sulaiman
Department of Orthopaedics
School of Medical Sciences
0129896565
background
● Incidence of clubfoot– 1- 6.8 per 1000
● Treatment is Ponsetti methods– manipulation and casting– bracing
Copyright ©2004 American Academy of Pediatrics
Morcuende, J. A. et al. Pediatrics 2004;113:376-380
Fig 2. Serial photographs at weekly intervals of the correction of a severe clubfoot deformity in a 3-week-old infant
Fig 2. Serial photographs at weekly intervals of the correction of a severe clubfoot deformity in a 3-week-old infant. A, At initial visit. B, After first cast. C, After second cast. D, After third cast. E, After fourth cast. F, Treatment result after percutaneous tendoachilles tenotomy.
Copyright ©2004 American Academy of Pediatrics
Morcuende, J. A. et al. Pediatrics 2004;113:376-380
Fig 3. Foot-abduction brace
-a bar with shoes attached at the ends .
-full-time basis for 2 to 3 months
- at night and during naptime for 3 to 4 years
● North america (Ponsetti centre)– Recurrence is 5%
● New Zealand– Recurrence is 45% due to poor complince to
abduction brace.
Reason for poor compliance
● Child refuse to sleep and keep crying● Especially if the treatment started after 3
months● It prevent a bigger child from walking
Aim of the project
● Primary aim:– Allow the child to sleep in various position yet
keep the feet in abduction.
● Secondary aim:– Allow the child to walk with the feet in
abduction
Step I
● Find the movement angle in normal population– Base on foot
progression angle= M1 and M2
M1M2
Step 2
● Find the range of angle in front and hind foot – Maximum degree of
M1 + M2 to be determined by measurement of gait in normal population.
Step 3
● Production of hinge between bar and shoes– Allows reciprocating
(Rt and Lt) movement M1 and M2
– Keeping the foot at 70 degrees abduction
Hinge between bar and shoes
● Location at the side instead of sole– For walking
● Dynamic instead of rigid– Walking
– Different legs position during sleeping
Step 4
● Pre- trial– Clinical usage under supervision
● Refinement of construct
Step 5
● Clinical trial– Compliance
● Walker● nonwalker
– Result
– Sustainability of the brace
Potential benefit
● All ctev patients– Especially bigger child
● Noble invention– Publication in High impact factor journal
● Market– National regional world market