Three weeks after the final cast is removed, your child will be fitted into a brace (foot abduction orthosis) designed to prevent the clubfoot deformity from recurring. Even when well corrected, the clubfoot has a tendency to relapse until the age of approximately four years. The brace must be worn as prescribed to prevent relapse. If worn as prescribed, there is a 95 percent chance that no other treatment will be necessary. Use of the brace will not cause developmental delays of your child. Children will still learn to crawl and walk even in the brace.
The brace consists of a custom molded insert with an AFO (ankle foot orthosis). The AFOs are attached to an articulating aluminum bar with adjustable footplates. The orientation of the footplates to the bar is set by the orthotist. Parents will be instructed on use of the brace in the clinic.
It is absolutely necessary that the brace be worn 23 hours a day for three months and then 12 - 14 hours a day (naps and nighttime) for 3 - 4 years.
You will also be taught stretching exercises for your child's foot that are to be done four times a day to maintain ankle flexibility. Begin with five repetitions and work up to 40 repetitions - four times a day. Be consistent with the stretching. Distract your child by singing or playing while stretching and they will adjust to the exercises within a month.
It is important to be consistent with nighttime brace wear early in the treatment process, since the child will wear the brace only at night when he or she begins to walk.