1. Clubfoot Orthotic William Porter Alexis Wickwire Erika Franzen Dr. Morey Moreland 02/08/2005 Bae Orthotics

2. What is Clubfoot? Talipes Equinovarus Congenital Deformity or acquired condition Affects bones, joints, muscles, and blood vessels Occurs once per 1000 live births is the U.S. The foot is pointing downwards and twisted inwards

3. More Facts on Clubfoot ~100,000 born each year in the world 5 to 7 times more children born with it in third world countries Almost half babies born with the condition have bilateral clubfoot In Uganda 10,000 current cases 1,000 born each year Only one trained surgeon to treat condition Need a non surgical answer to the condition

4. Treatment Options Physiotherapy - The aim is to stretch the ligaments and tendons into the correct position. Strapping - Strips of adhesive strapping are passed around the foot, up the sides of the leg, and over the top of the knee, to hold the foot in a corrected position. This is usually done weekly, following some physiotherapy. Plaster fixation - The surgeon manipulates the foot into position, and holds it in place with plaster. This needs to be repeated about every week for 3 to 6 months. Ponseti Method - The treatment involves weekly stretching of the foot deformity in the clinic, followed by the application of long leg plaster casts. The cast is changed every 1 or 2 weeks. The physician may performs a tenotomy, an Achilles tendon lengthening using non-invasive surgery. Splinting - There are different types of splint available that may be worn just at night, or for most of the time.  Most reports only show a success rates of less than 50%.  Almost all of the treatments need to be followed by a braces to hold the foot in the correct position for an extend period of time.

5. An infant with unilateral clubfoot An infant with bilateral clubfoot An infant being treated with castings

6. Current Braces Dennis Brown Bar Wheaton Brace Problems with current braces: Expensive ($200 to $300) Uncomfortable Hard to keep children in them Parents will allow kids to take it off because cause discomfort They do not keep feet at optimal position DBB – both feet must be kept in brace

7. The Primary Objectives Fabricate an orthotic device to successfully treat patients (approximate age 1-3 years) Improve comfort and wearability of the orthosis Formulate a design to prevent distraction of the foot from the orthosis, as commonly occurs with currently marketed devices Construct a more economical device for non- invasive treatment to a costly health condition

8. Achievements to Date Guidance by Dr. Moreland on the condition and current methods of treatment Decided on a preliminary design Contacted companies about buying portions of the prototype from standard orthotic parts Obtained a Dennis Brown Bar to examine and model our device after

9. Conditions for Success Hard to find a infant with clubfoot to test prototype If the brace: Holds the foot in the correct position for extend periods of time Comfortable for infant to wear Cheaper than other braces on the market

10. Personal Role Brainstorm possible redesigns of device Construct prototype Drawings of possible redesigns Implement validation and verification protocols on the prototype Clinical evaluation of prototype

11. Questions ?