Specialty Clinics

Esmeralda Tule:

Your child has been diagnosed with clubfoot. Welcome to the largest clubfoot clinic in the Western United States, the Utah Clubfoot Clinic.

Esmeralda Tule:

In this video, we will be covering the process of the clinic, and answering the most common questions. Meet Dr. Hennessy, one of our clubfoot specialists.

Dr. Theresa Heenessey:

Hi, I'm Dr. Theresa Hennessey. I'm a pediatric orthopedic surgeon at Shriners Hospitals in Salt Lake City, Utah.

Screen: What is the Utah Clubfoot Clinic?

Dr. Theresa Heenessey:

The Utah Clubfoot Clinic was established in 2015. Clubfoot is a very common condition, and we have a lot of patients in Utah and the region, and we wanted to establish a care model that took care of you, your children, and had the best outcomes possible.

Screen: How will clubfoot affect my child's life?

Dr. Theresa Heenessey:

As a parent, I know the anxiety of learning that your child might have a diagnosis that you don't understand. I want to assure you that clubfoot is very common. And I know that the question deep in your mind is, "How will this affect my child's life?" What you need to know is that clubfoot is a completely curable condition. And that if I do my part, and you do your part, your child will have a completely normal life while dealing with this diagnosis. While having a newborn infant is stressful, and having a clubfoot adds a little bit of stress to that together, as a team, we are going to do a great job in treating your child's clubfoot.

Screen: Meet the Team.

Dr. Theresa Heenessey:

Our team at the clinic consists of three physicians and a physician's assistant. Each of us, the physicians, have over 15 years of treating clubfeet, or our physician assistant has about 10 years of treating clubfeet. We see a lot of feet and we do a very good job. All four of us have extensive training in the clubfoot Ponseti method.

Screen: What is the Ponseti method?

Dr. Theresa Heenessey:

The Ponseti method, established by Dr. Ponseti in Iowa, is the gold standard for treating clubfoot worldwide. It does have to be said that not all clubfeet are idiopathic clubfeet. An idiopathic clubfoot is a foot that has no other associated conditions. There are some feet that are associated with syndromes. The first thing we will do when we meet you and your child is examine your child head to toe to make sure that we all understand exactly what condition we're dealing with.

Screen: How long does it take to fix a clubfoot?

Dr. Theresa Heenessey:

The Ponseti method of treating clubfoot, again, the worldwide standard is an average of six weekly casts with the last cast being on for about three weeks after a minor procedure to lengthen the Achilles tendon. After the casting, we go into bracing. The bracing phase is full-time brace wear for about three months, followed by 12 to 14 hours a day, or nighttime brace wear for about 3 1/2 years.

Dr. Theresa Heenessey:

The wonderful thing about the Utah Clubfoot Clinic is we're a team that really cares about you and your child. We created this clinic and have our own coordinator because we want you to have immediate access to us if there are any issues. It's a coordinated care, where you'll never feel like you're alone. You'll never feel like you don't know what to do. You'll have access to us and you'll feel completely cared for. We want the best for your child. And we can do that by working as a team together.

Esmeralda Tule:

Now, that we know what clubfoot is what's next?

Screen: First steps

Esmeralda Tule:

After the baby's born, the infant should be scheduled at two to three weeks of age for their first casting appointment. This first appointment will likely take anywhere from 30 minutes to an hour long. At this appointment, we will make sure that baby's hips are okay. We will make sure that his spine or her spine is okay. And do a full physical examination.

Screen: When will the casting begin?

Esmeralda Tule:

We will likely start the casting at this first appointment.

Screen: What to bring

Esmeralda Tule:

Babies do best with a pacifier or a bottle during the cast application. We have a child life specialist, whose job is to make your child comfortable during this process.

Screen: What is the casting like?

Esmeralda Tule:

Mom and dad are encouraged to be at bedside with the patient during the casting application. With the leg bent at a 90 degree angle, the cast is applied from the toes up to the top of the leg. The casting process usually takes 5 to 10 minutes per leg.

Esmeralda Tule:

Let me show you around. Here's the clinic room. This is where your child will be brought into for cast removal. There is a reserved bathing area for you to bathe your child before the next cast application. Because the cast cannot get wet, this is a good opportunity for you to bathe your child in between cast changes.

Esmeralda Tule:

We have our own in-house bracing department called POPS that collaborates with our clinic.

Screen: How long are appointments?

Esmeralda Tule:

A typical casting appointment usually takes anywhere from 30 minutes to an hour long. The appointment before your last cast, which is the tenotomy appointment will usually last a little longer. So, expect to be at the hospital for usually an hour longer than your previous appointments.

Esmeralda Tule:

After the tenotomy, your child will be placed on a final cast. This cast will stay on for three weeks. At the end of those three weeks, you will return to clinic, we will remove the cast. And then he or she will be placed in a bracing schedule, which usually consists of 23-hour, full-time brace wear for the next three months.

Esmeralda Tule:

Now, that you've gone through the virtual tour, if you have any additional questions, please visit the Utah Clubfoot Clinic at clubfootclinic.com.

Screen: clubfootclinic.com