Clubfoot: Boots-and-Bar

Wearing the Boots and Bar is a critical part of the Ponseti treatment. They maintain the correction that has been achieved with casting and the tenotomy (if performed). It is dependent entirely on the parents’ compliance. Taking the boots and bars off for only a few hours, or overnight can result in a relapse and may lead to the need for recasting.  Parents can find this stage of treatment challenging but persistence will result in the best possible outcome. We are always available to discuss strategies to help you and your child.

Tips and Tricks:

• Seamless cotton socks are the preferred choice

• Make sure you are not using double layered socks- this can cause friction and redness on the front of the ankle

• The socks should cover the entire area that the boot touches

• Pull the sock a little at the toe if there is a seam and if it seems snug against the toes to prevent rubbing

• When the orthotist fits the boots they will mark the straps so you know how tight they need to be in the first days when the child is getting used to them

• The leather straps will stretch with time and as the foot gets bigger you may need to change which hole is used

• Use the holes at the back of the boot to check that the heel is flat 

• Start with the middle strap to ensure that the heel stays flat and then strap the top and bottom

• Make sure you understand how to adjust the boots yourself so you don’t get stuck in the event of a problem

• Make it part of the child’s daily routine and make sure they understand it is non-negotiable

• If sore or red patches appear you can use 2nd skin bandages and make sure you contact the office to discuss other options

• Do not use lotion on any areas of redness as that can make the situation worse by enabling more motion and friction

If you have any other helpful tips you would like to share please let us know! 

As always, if you have any concerns or issues please reach out to us at 212-305-5475 or pedsortho@cumc.columbia.edu.