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Boots & Bar – A Guide for Children with Club Foot

Introduction

If your child has been diagnosed with Congenital Talipes Equino Varus (CTEV) commonly referred to as Clubfoot, you have likely seen an orthotist who has fit your child with a Boots & Bar type orthosis.

Following the serial casting by your Physiotherapist/Orthopaedic Surgeon, children are fitted with Boots and Bar to maintain the correction achieved during the casting process and following the Achilles tenotomy, in many cases.

My Child Has Red Marks On Their Feet

It is common to notice red marks appear on your child’s feet when you remove the boots and bar. This is normal and expected. These red marks should fade within 20-30 minutes of removing the boots and bar. These often settle as your child settles into wearing the boots and bar.

What Do We Do If The Red Marks Stay?

If red marks do not fade they may be areas where blisters may occur and these are often at the back of the heel. Make sure that there are no wrinkles in socks and the ankle strap is firm so that your child’s heel cannot ride up inside the boot. If these measures are not successful, contact the Orthotist immediately.

What Happens When The Child’s Feet Grow?

When your child’s feet grow please contact your orthotist to arrange replacement boots.

The bar will be adjusted as your child grows. Normally the boots will fit for approximately 4-6 months but this varies depending on how quickly their feet grow and how long the treatment is needed.

Conclusion

We hope this has answered your questions regarding this part of the treatment.

If you have any further questions, please feel free to contact your Orthotist.

HOW DO THEY WORK

The boots and bar are positioned to have a similar position of the foot to the casting position. This has 3 parts:
1. Toes turned outwards 2. Feet tilted inwards 3. Ankles held at 90 degrees

USING THE BOOTS

How Long Should They Be Worn?

The boots and bar will be fitted within a few days of or on the day the last cast was removed. Initially, you will need to let your child gradually get accustomed to wearing the boots and bar. Boots and bar should be worn 23 hours a day.

When Should They Be Removed?

The boots and bar should be removed for bathing. If you wish, you may remove them before bath time or leave them off for a little while after bath time. Some parents prefer to give their child 2, 1/2 hour breaks during the day. Either method is acceptable. Enjoy this time massaging and stretching your child’s feet and let them have a good kick.

How Often Are They Checked?

In most cases, your Physiotherapist/Orthopaedic Surgeon will initially review your child every 2 weeks and then monthly. The Orthotist is available at these appointments for adjustments or to answer questions.

Removal Of Boots & Bar

The total period of time your child will wear the boots and bar will depend on their feet and their progress. Initially, boots and bar are worn for 23 hours a day for the first 3 months and then are worn at night and for naps until your child is 4 years old.

APPLICATION

The Orthotist will show you how to put them on and take them off when they initially fit the boots and bar.

Some key points to remember when putting them on:

1. Make sure the heel is right down into the back of the boots.

2. Firmly fasten the middle ankle strap first. Note: Buckles go on the inside of the foot.

3. Firmly fasten the top and bottom straps.

4. Attach bar to the boots.

REQUEST APPOINTMENT

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