What are Boots and Bar?
Once your baby’s foot/feet have been corrected using the ponseti method, a foot abduction brace (Boots and Bar) will be used to hold the new position of the foot. The boots and bar are an important part of treatment because the clubfoot deformity will relapse back to its original position if not held with the boots and bar.
Relapse will usually presents with the foot turning in and the calf muscle becoming tight. This occurs in up to 30% of cases. Your child may require further casting or surgical intervention if/when this occurs. Boots and bar will help to prevent relapse.
What do the Boot and Bar look like?
Your baby’s feet are placed in a special boot that has a high top (extends above the ankle). The boot has a straight border along the inside of the foot and open toes. The boots attach to an adjustable bar at shoulder width apart. The position of the boot on the bar is adjusted to hold the corrected foot in an outwardly rotated position of 60-70 degrees. The untreated foot is held at 30- 40 degrees outwardly rotated position.
How long will my child need to use the Boots and Bar brace?
The brace is worn for 23 out of 24 hours for the first three months. After this time, your child will use them for nights and naps only until your child is approximately four years old. The brace is 90% effective in preventing a relapse when used correctly.
Most babies take a few nights to get used to wearing the brace. The use of the brace will not delay your baby’s development in sitting, crawling or walking.
Who will fit the boots and bar brace?
The foot abduction brace will be fitted by an Orthotist. You will have regular appointments with your child’s Orthotist to monitor your child’s progress with the brace. Your orthotist will teach you how to put on the boots and bar and how to check it is fitting properly.
Tips for boots and bar use
- Routine – Most parents report that their baby copes best with the brace if it becomes part of their routine. Aim to put the boots and bar on at the same time in your baby’s routine and in the same place each time. This reinforces brace wear and makes the brace part of your child’s routine.
- Skin – Protect your child’s skin by using cotton socks inside the boot.
- Putting the brace on – Ensure your child’s heel is down within the shoe. Do up the ankle strap first to help position the heel down into the shoe.
Speak with your Orthotist if you have any concerns about how the foot abduction brace is fitting.