Club Foot Update - 1/8/9

"It's not what it looks like . . . I didn't do it . . . "

Yes, little Houdinibelle did wiggle out of her left cast for the third time however that's not why she only has one on now . . .

After looking at the x-rays from last week with the Doctor, it looks like just about all the correction that can be done with casts has been done.

The doctor offered to leave the casts off for a week if we felt like we needed a break . . . we replied that the casts really are the least of our worries and we wanted the doc to cast or not cast strictly based on what he thought would be medically best. He decided that casting probably would not do much good for the right foot at this point but Annaballarina's left foot is still pointed downward pretty good so he decided to just cast the left foot and try to get her toes to angle up a little more.

The other thing we learned from the xrays is that the "big" surgery is in order and will probably happen in February or March depending on facility / doctor availability.

Here is the situation as best as I can describe it . . .

The Calcaneum is basically your heel bone. If you draw a line through it's axis (divide it in half the long way), that axis pretty much is in line with the center of your foot.

In Annie's case, her feet were turned outward so they have been trying (among other things) to get her feet to turn forward to the typical position through casting.

Due to the resistance in her feet and ankles, Annie's heels have not turned as much as the rest of her feet so that if you draw an axis through the Calcaneum, instead of that line extending down the middle of her foot, it extends outside her feet past the pinky toe. Her right foot is a little more severe in that regard than her left but both have a similar condition.

The surgery is called a "Post Medial Release" or PMR. The doctor will go in, cut some of the tissue and tendons that are providing the resistance to correction, place the bones in their proper alignment, insert pins to keep everyone where they belong, and then wrap everything in a cast for about 10 weeks.

This will allow healing and development to begin in proper alignment. Eventually the casts and pins will be removed.

So that is the ortho update. On another note, the xrays also gave some indication as to the musculature of Annabelle's legs.

In the xrays, you can see the black margins, the white line where Annabelle's skin is, the grayish area of tissue in her leg and the white image of the bones. But when you adjust the contrast on the xrays, you can discern another white line - similar to that of Annie's skin, about half-way between her skin and her bones. This is where the baby fat ends and the muscle tissue begins.

The doctor explained that typically, fat will show up darker than muscle due to the density. In Annabalu's xrays, there is very little contrast between the baby fat and the area of the muscle. This can be an indication of lack of muscle tone or even lack of proper musculature.

When babies develop, all the muscle cells reproduce in all the right places - but they need stimulus from your nervous system to complete the development, otherwise the muscles are sort of just areas of fibrous tissue rather than proper muscles.

This seems to be the case in Annabelle's situation.

It was hard news to see and hear as it gives further weight to the idea that our little girl may never get the use of her legs.

This , of course leads us down the road to the intersection of faith vs reason but I suppose that is a topic for another post.

So that is the latest. We will be going back to the Dr to get her left cast changed next week and begin the process of scheduling the surgery on her feet.

Thank you for all your continued prayers and support!