Dynamic abduction brace for Clubfoot

Abdul Razak Sulaiman

Department of Orthopaedics

School of Medical Sciences

abdrazak@kb.usm.my

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