The cost of the Cunningham Brace and treatment including all consultations at LOC is as follows:
Club Foot Treatment package from £2,400
Depending on the age of the child when LOC’s treatment commenced and the rate of growth of the child a replacement brace may be required. The costs of the second brace are the same.
|Unilateral Club Foot Treatment Contract (DTKAFO)||from £2,400|
|Bilateral Club Foot Treatment Contract (DTKAFO)||from £4,200|
|Please note: Depending on the age of the child when LOC’s treatment commenced and the rate of growth of the child a replacement brace may be required. The costs of the second brace are the same.|
Club foot, or clubfoot, is the general name given for a medical condition called congenital talipes equinovarus (CTEV). Congenital means that you’re born with the condition, which can occur in one or both feet. It is quite common, occurring in around one in every 1,000 babies born in the UK.
The affected foot will look like it’s rotating internally at the ankle, with the foot pointing down and inwards. The soles of the feet face backwards. If left untreated, people with club feet often appear to be walking on their ankles or the sides of their feet.
Young babies are naturally flexible, and we can use some of that to correct club foot. There are stages to that process and most cases respond well to correction using the Ponseti method (see question four) followed by a long period of maintenance using what is known as the ‘boots and bar’ approach.
LOC does not carry out the Ponseti method directly. Instead, we see patients who are referred to us or who have already been seen by club foot and Ponseti experts. Typically, we work with patients in that final boots and bar stage. However, we are pioneering the use of a different brace, known as the Cunningham Brace (see question six).
We are the only clinic in the UK and Europe offering Cunningham Brace treatment and we will only proceed if our clinical judgement is that your baby’s condition has been fully corrected by Ponseti treatment.
The Ponseti method involves manipulation and repeated weekly casting for about five to eight weeks. After that, a small procedure called a tenotomy is carried out under local anaesthetic to lengthen the tight heel cord – known as the Achilles tendon – in the back of your ankle. The treatment follows very strict, well-understood protocols and is the gold standard in corrective treatment for club foot. Indeed, the procedure is used and endorsed by Great Ormond Street.
This is the second, long-term stage of treatment, once the Ponseti method is complete. Just as it sounds, this treatment involves wearing a pair of special boots – full time – for the first three months after treatment and then overnight until the child is around four or five years old. Both feet are essentially strapped together, which is an enormous undertaking meaning that compliance is critical for success. While success rates are high, we know a lot of parents find the process very challenging. That’s why we work with the Cunningham Brace.
The Cunningham Brace was designed by Jerald Cunningham, who runs his own clinic in the US. It works using a firm strap around the thigh and a spring that holds the brace up against the bottom of the foot. This means that the brace is always gently stretching your baby’s foot into the correct position, in a similar way that a therapist applies manipulation.
Jerald developed the brace at the request of an orthopaedic surgeon and colleague who saw how distressing the boots and bar process was for many children and parents. Jerald has worked on the design for more than 10 years, tweaking as he goes, based on x-ray evidence after every patient fitting.
At your first appointment we will take measurements and fit your child with their first Cunningham Brace. We’ll show you how to put the brace on and take it off and book you in for a review a week later. We then schedule a series of reviews as your child grows to check progress and ensure that your child is maintaining the correction. This can be done in the clinic or virtually via a system like Skype. There are lots of simple things we can adjust to encourage correct development.
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