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Old 18th August 2009, 01:12 PM
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Default Re: Ponseti Method for clubfoot

Our OT at the hospital sometimes does an aquaplast splint for positional talipes.

I guess in a remove community, even conservative care is difficult, you only need some sand to get into a plaster cast and have a wound start. While I think there is a great number of things that could be done, even with a soft cast, but the social factors are so huge. Is there a nurse always there, is there a podiatrist there 2-3 x a week, do they even want it treated?

The other, is how much it had changed in the last year. When they saw him last year, was he walking, weight bearing etc, the ortho may not have noted the extend in the 10 minute visit they are afforded in current health system. If this child's parent weren't equipped for that environment to push for treatment there is always a wait and see approach. There may also have been the discussion of casting there at the hospital but the parents wanted to go home rather than stay for 6 weeks so they just have to wait for surgery which I dare say will be booked at the next review in Dec. However with his flexibility, he may still be casted at the next review. Don't forget, unless you have that little paper that says you are ponsetti trained (here in Australia) and an ortho likes you, you will not be trusted to do ponsitti casting. You "may" be trusted to fit a dennis brown bar, maybe.

This is one of the hardest and most infuriating things about seeing complex rural patients, is the minimal amount of interventions that can be provided, and the inadequate health system setup for unemplowered patients. I understand your frustration. These are the clients that we will often try to attend the ortho appointment with to we can understand what is going on and how we can work together but we have that luxury in the community health and hospital system that is close to each other.
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