Boots & Bar

When the final cast has been removed (either after the serial casting or the tenotomy) and your baby’s feet are beautifully corrected, your baby will start a crucial part of the talipes treatment process. The wearing of the “boots & bars” is to prevent your baby’s clubfeet from relapsing. At this stage of the treatment there is about a 90% chance of your babies clubfoot relapsing if you were to stop treatment now.The wearing of the boots and bars is definitely the most challenging phase for parents. Some babies and children may feel distress initially at being unable to move their legs freely, but they do adapt.Initially your child will wear the brace for 23 hours a days for three months. After that they need only wear it during the night and at nap times. No matter what your babies reaction is to the boots, it is vital to persevere with them. Not wearing the boots is not an option.There are several options of boots available, although in Australia the Markell boots and bar is most frequently used. This is due to availability and cost. Another option available in Australia is the JS Essential Boot which is similar to the Mitchell boot. This boot comes with the Horton Click Bar which easily snaps on and off the bottom of the boot. Another type of boot and bar, popular in USA and UK is the Mitchell brace. It differs to the Markells in that the bar clicks on and off the boots which can make life a little easier. They also do up with three buckles, which, in our own experience, we found easier to get on our child’s feet. In terms of which is best for the treatment, that comes down to personal opinion. If your baby/child has no problem wearing the Markell boots, then there is no advantage in switching to the Mitchell.There is also the option of a custom made ankle-foot orthosis (AFO). Your Doctor or physiotherapist will advise you is these are beneficial in your situation.

Below are images of the Markel, JS Essential, Mitchell boots and a pair of custom made AFO’s.

The next question is “How long does my child have to wear the boots & bar?”. Currently the advice is to wear them until your child is 4 years old, unless your Doctor advises otherwise (in some cases it might be longer). Don’t let this daunt you. While there is no doubt it will become challenging at times, it will not become impossible. Especially with the support of other parents going through the same challenges as you.