Pediatric foot and ankle disorders while shadowing

[smartman716]

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While shadowing, I got to see my first pediatric clubfoot case a little while back and I forgot to mention this. I saw about four children ages 0-13 altogether. Please share your Podopediatrics experiences with the Pre-pods.

 

[rom3o]

We get a lot of club foot kids in through our office (I'm pre-pod, btw). Most of the referrals are from orthopedists though, I guess pediatrics isn't too popular amongst DPMs in my area.

The more severe cases have had surgery (not entirely sure what this process consists of) followed by serial casting. Then they usually come by our office for dennis browne bars and ponsetti shoes, or on occasion some custom-molded SMOs or other type of orthosis.

Pediatric-wise a lot of CP kids with tone issues. I'm not that big of a fan of working with little kids, you need a lot of patience.

 

[dropfoot]

The only pediatric case that i have seen so far was a young girl with type one diabetes; it was basically just a consultation for the parents on how to care for the feet, but it was still pretty cool. Podiatrists rock when it comes to saving limbs.

 

[rom3o]

The only pediatric case that i have seen so far was a young girl with type one diabetes; it was basically just a consultation for the parents on how to care for the feet, but it was still pretty cool. Podiatrists rock when it comes to saving limbs.

Ah, that reminds me, we did have a kid in last week that had CMT neuropathy. Rx was for a pair of SMOs

 

[smartman716]

Ah, that reminds me, we did have a kid in last week that had CMT neuropathy. Rx was for a pair of SMOs

rom30 you guys get a lot of cases. What are SMO's?

 

[rom3o]

I work for an Orthotic & Prosthetic company so we get our fair share of pediatrics -- it's the largest O&P company in the nation so we get a lot of referrals because of contracted rates with insurance companies and because we are well known.

I really enjoy working with the lower extremities, but from a pediatric perspective we see all sorts of things: from scoliosis braces to pectus carinatum braces to cranial remolding orthoses, etc. -- I would rather be working with the F&A

Anyhow, that was off topic, to answer your question,

SMO (or SMAFO) is Supra Malleolar (Ankle) Foot Orthosis. As the name indicates, it goes up over the ankle -- it's late and I'm tired so I'll see if I can wiki something for you.

The supramalleolar orthosis (SMO) controls severe pronation and supination, and it is good for toddlers moving from floor activities to standing and walking. SMOs can be used with more straps for further stability and control, or elastic or fewer straps to progress the child. A common strategy is to get a child a taller brace with more straps and then remove the straps and cut the brace down as the child gains stability and strength.

Source: http://www.ptproductsonline.com/issues/articles/2006-10_04.asp

They are not limited to peds though, we make them for adults too.

I haven't shadowed a DPM yet, but do look forward to it, especially the surgical cases.

 

[dropfoot]

I work for an Orthotic & Prosthetic company so we get our fair share of pediatrics -- it's the largest O&P company in the nation so we get a lot of referrals because of contracted rates with insurance companies and because we are well known.

I really enjoy working with the lower extremities, but from a pediatric perspective we see all sorts of things: from scoliosis braces to pectus carinatum braces to cranial remolding orthoses, etc. -- I would rather be working with the F&A

Anyhow, that was off topic, to answer your question,

SMO (or SMAFO) is Supra Malleolar (Ankle) Foot Orthosis. As the name indicates, it goes up over the ankle -- it's late and I'm tired so I'll see if I can wiki something for you.



They are not limited to peds though, we make them for adults too.

I haven't shadowed a DPM yet, but do look forward to it, especially the surgical cases.

Your experience is great; it will serve you well.

 

[smartman716]

I work for an Orthotic & Prosthetic company so we get our fair share of pediatrics -- it's the largest O&P company in the nation so we get a lot of referrals because of contracted rates with insurance companies and because we are well known.

I really enjoy working with the lower extremities, but from a pediatric perspective we see all sorts of things: from scoliosis braces to pectus carinatum braces to cranial remolding orthoses, etc. -- I would rather be working with the F&A

Anyhow, that was off topic, to answer your question,

SMO (or SMAFO) is Supra Malleolar (Ankle) Foot Orthosis. As the name indicates, it goes up over the ankle -- it's late and I'm tired so I'll see if I can wiki something for you.



They are not limited to peds though, we make them for adults too.

I haven't shadowed a DPM yet, but do look forward to it, especially the surgical cases.

Very useful resource, thanks. Anyway, since you are yet to shadow a DPM and see an actual surgical case, here is a google book link on pediatric foot and ankle surgery for you to feed your eyes with

http://books.google.com/books?id=f3...=X&oi=book_result&ct=result&resnum=10#PPP1,M1

The author is Richard M. Jay, DPM


and to quote dropfoot "Podiatrists rock when it comes to saving limbs".

 

[gustydoc]

Podopediatrics is a great niche in medicine if you are interested in it. For lots of reasons many docs don't have the desire to work on the pediatric population so the need is certainly out there. At my residency program we spend a lot of time at the Childrens Hospital of Michigan on Pediatric Orthopedics. We have clubfoot clinics and see everything from congenital met adductus to vertical talus. We even had a resident stay after residency and complete a 1yr MD Pediatric Orthopeadic fellowship so the opportunities are out there if you are driven and work hard.

 

[streetsweeper]

Podopediatrics is a great niche in medicine if you are interested in it. For lots of reasons many docs don't have the desire to work on the pediatric population so the need is certainly out there. At my residency program we spend a lot of time at the Childrens Hospital of Michigan on Pediatric Orthopedics. We have clubfoot clinics and see everything from congenital met adductus to vertical talus. We even had a resident stay after residency and complete a 1yr MD Pediatric Orthopeadic fellowship so the opportunities are out there if you are driven and work hard.

Word. Not only is it a great niche but highly unfilled niche. Dr. Michael Colburn, DPM (residency director from one of the Kaisers) is the only DPM in all of california approved by Dr. Ponseti MD himself to treat clubfeet. And one of 2 physicians in all of northern california. And we got the privilege to hear his lectures on clubfeet.

http://ponseti.info/parents/index.php?option=com_content&task=view&id=13&Itemid=28

The ponseti method is a modified version of traditional serial casting and has a very high success rate with minimal surgery involved. It starts by correcting met adductus/cavus FIRST before correcting any equinovarus.

Congenital Clubfoot:
Fundamentals of Treatment by Ignacio V. Ponseti
Publisher: Oxford University Press; 1st edition (January 15, 1996), ASIN: 0192627651

 

[gustydoc]

Our third year residents actually have the option to go to Iowa city and spend time a month with Ponseti and his Fellows learning the technique firsthand. One of my co-residents was there a few months ago and said it was an awesome experience. The bummer is that Ponseti is planning on retiring soon so if you want to learn from the Godfather you better hurry.

 

[smartman716]

When will the Godfather retire? I hope others follow suit. I personally would like to go learn from him but it's still a bit too early.