What shoe options do I have when using the dynamic bar?
We offer a complete clubfoot solution featuring two custom made AFOs. The advantage of this system is that the shoes are custom made to fit the feet. This is particularly advantageous in situations where the shape of you child's foot may not fit well in off the shelf shoes. Having a well fitted clubfoot shoes system will often avoid complications such as skin blistering.
What do I do if my child's heel is coming up out of the Clubfoot AFO?
The affected foot should be corrected enough so that the child's heel is able to lie properly inside of the AFO. If you child's foot is not flexible enough to completely go down into the AFO then discontinue use of the AFO and contact your treating physician.
Once you are assured that the feet are corrected well but the heels continue to slip in the brace than further trouble shooting is warranted. The first thing to try is re-tightening the middle strap. It is crucial to have the middle strap snug in order to keep the heel down and a common mistake when putting the brace on is not to tighten the middle strap enough.
If there are continued problems keeping the heel down then the next thing to assess is the child's socks. Your child should be wearing socks at all times with the Clubfoot AFOs. Make sure the initial sock is snug and does not have any wrinkles in it before applying the molded inner boots and AFOs. A second pair of socks can then be placed over the transparent plastic molded inner boots. The feet are then placed in the firm outer shells and the Velcro closures refastened.
The last trouble shooting tip is to have your orthotist add a horseshoe shaped pad in the heel of the transparent molded inner boot to keep the heel from slipping inside of the AFO.
What do I do if my child is un-strapping the Velcro closures?
If your child is unstrapping the top strap then apply a slightly longer sock and roll the top of the sock down over the top strap of the AFO. In addition, the socks should be snug with no wrinkles. This will prevent the child from getting a hold of the Velcro and opening it.
If your child is opening the middle instep strap then have your orthotist cut the strap short and tuck the end of the strap between the wall of the outside AFO and the molded inner boot. This same procedure can be used on the bottom strap.
My child is perspiring a lot in the Clubfoot AFOs, is this normal?
Yes, especially in the first two weeks until you child gets used to the AFOs. We recommend that you change your child's socks every time the brace is removed and wipe the transparent molded inner boots out with rubbing alcohol. At first you may have to do this 3-4 times a day. The perspiring problem will get better over time as the child's body regulates itself. It is also a good idea to remove your child's socks when he/she is not in the brace so that air can get to the skin and dry up any moisture.
How do I tell if my child's heel is slipping inside of the Clubfoot AFOs?
Take a pen and mark a line at the child's toes on the front of the transparent molded inner boot. If the toes are migrating off of the marked line then it is likely that your child's heel has slipped in the AFO. Take off the AFOs and re-apply them. If this is the case please refer to the tips outlined in paragraph two above.
How do you order the complete clubfoot AFO?
The best way is to have the orthotist take casts and send the casts in with the AFO order form found on this website. Include your order form with in the shipping box with your casts. If you take casts then we only need a shoulder with measurement, you do not have to take any other measurements. The second way is to fax us your AFO order form with all seven measurements and then we will pull a mold and modify it to your measurements. If you have any questions call (314) 968-8555 ext. 102.
What is your turn around time?
If you are ordering just the Dobbs bar alone then orders place before 3:00 pm CST will be shipped out the same day. Orders after 3:00 CST will be shipped out the next day. Turn around time for a complete clubfoots system (with AFOs) is two days in shop from the time we receive the cast or measurements. It is important to fill out the AFO order form completely. Incomplete order forms could delay production until we can contact you to obtain the missing information.
What size Dobbs Bar should I order?
The Dobbs bar comes in two sizes both of which are expandable. The small bar expands from 6 to 9 inches while the regular bar expands from 9 to 14 inches. The Dobbs Bar should be set so that the width of the bar is slightly wider than the width of the outer edge of one shoulder to the outer edge of the other shoulder. If the child's shoulder width measures 8 inches or above use a Regular Dobbs Bar. If the Shoulder width is below 8 inches use a Small Dobbs Bar.
Is the Dobbs Clubfoot System approved for the less common complex/atypical clubfoot and non-Idiopathic clubfoot?
Yes. The Dobbs brace is being used with great success not only for idiopathic clubfeet but for complex clubfeet and non-idiopathic clubfeet. Most clubfeet are idiopathic in nature which means that the child has no other significant medical problems. Non-idiopathic clubfeet, though less common, are usually more difficult to treat. Patients with non-idiopathic clubfeet include those patients who have myelomeningocele, arthrogryposis, or a genetic syndrome. The last type of clubfoot is the complex or atypical clubfoot which usually occurs in children with no other know medical problems. The complex clubfoot is characterized by feet that are short, wide, and more resistant to casting and bracing. The Dobbs Clubfoot System is ideal for treating these difficult feet because the shoes are made to fit the feet. A shoe that is well-fitted often results in better tolerance of bracing and less risk of clubfoot relapse.
How are Markell Shoes attached to a Dobbs Bar?
The Dobbs Bar was designed to work with TARSO Open Toe Boots from Markell Shoe Co. Our foot plate has two holes that correspond to the two holes in the bottom of a TARSO boot. You simply screw the Dobbs foot plates onto the bottom of the TARSO shoes. Click here to view Markell TARSO Boots.
Can the Dobbs Bar be attached to Ponseti AFOs?
Yes. In order to attach Ponseti AFOs from MD Orthopaedics, a special Dobbs Bar with Mitchell Adaptors must be ordered from D-Bar Enterprises. In addition, a hardware kit from MD Orthopaedics is needed if you do not already have a Ponseti Bar. Most distributors only carry the regular Dobbs Bar. Note: A regular Dobbs Bar will not attach to Ponseti AFOs, you must order one with Mitchell Attachments.
If I already have a Dobbs Bar can I convert it to work with Ponseti AFOs?
Will the Dobbs Bar result in equinus problems if used with regular shoes?
No, this is a myth. There is no data to support such a claim. The advantage of the dynamic bar is that children can actually use their muscles more both at the knee as well as the ankle promoting increased motion in general. In addition, setting the shoes in external rotation on the bar, which is required for maintaining clubfoot correction, actually promotes ankle dorsiflexion and not equinus.
