Kyle Moody was born to Ryan and Elicia in Houston, Texas on June 18, 2007 with bilateral clubfeet. Clubfeet is a birth defect that affects about 1 in every 1000 babies, and is more common among families with a genetic history of the problem.  While we haven't found any history of it in our family (update: we've recently found cousins on both sides who had the deformity), we were lucky to have it diagnosed as early as the 21st week of pregnancy.  I say this is lucky because we had plenty of time to prepare for his treatment.  For the unlucky parents who are surprised by this problem at their child's birth, it can be frightening.  Fortunately, clubfeet is completely fixable and he will look and play like a normal child. 

 We started Kyle's treatment of serial castings on his fourth day of life.  We found a doctor at the Fondren Orthopedic Center in Houston who follows the Ponseti Method of non-surgical correction.  He will have up to 6 sets of casts, changed weekly, with the last one staying on for three weeks to allow for complete healing after a small incision to his Achilles tendon.  When the last casts come off, his feet will look normal, though there will be some overcorrection.  He will then have to wear a special brace made up of shoes secured to a bar at a 70degree angle outward.  This brace (called a Dennis Browne Bar, or Mitchell Brace) had to be worn 23 hours per day for three months to hold the correction.  After that, he will wear the brace when he sleeps until he is 3 years old.  All said, not so terrible a price for him to walk and run like a normal child, and likely have no pain associated with his feet when he grows up (unlike surgeries which often result in chronic foot/ankle problems later in life).

We've done our best to document Kyle's transition from really screwed up feet to cute and outward-pointing little piggies. Here are the pictures we've taken along the way.

This is what his feet looked like at birth.  He could kick his bottom with the soles of his feet (and did, during diaper changes!).

June 22, 2007  First Casting (4 days old!)

June 29, 2007  Second Casting

We were told by Dr. Epps in Houston to soak off the first casts as close to the appointment time as possible, so the morning of, we broke out the tub.  But his umbilical stump was still there, so we got imaginative!

July 10, 2007  Third Casting

July 17, 2007  Fourth Casting

July 24, 2007  Fifth Casting

August 1, 2007  Tenotomy and Sixth Casting

August 22, 2007  End Result and New Shoes

The casts were removed three weeks after the tenotomy and his feet looked great!  We were surprised to find out, though, that the shoes/brace he would have to wear for the next three to four months take a day to make, so his feet were free for about 30 hours.  Dr. Epps prefers this special brace that's built specifically for his feet, so on the 22nd they took a casting of his feet and calves and we went back on the 23rd to get it. He fit in it perfectly, and didn't even fuss when the orthotist put it on him at the full 70 degree outward abduction (10 degree dorsiflexion).  After a very fussy first day of wearing the brace, though, we turned it down a notch to about 60 degrees out and he was much more comfortable.  The next day, though, we worried about losing any of the progress we'd made, so we put it back at 70 and he's been happy with it since. 

His first night in the brace he pulled a Houdini and unscrewed himself from the bar!  He didn't sleep well that night or the next day, but his second night he slept 8 hours for the first time in weeks.  He's a good boy handling all this craziness very well.  It's perfect training for his snowboarding/skateboarding career!

After 6 weeks in the above brace, he outgrew it, and we got a different kind of brace actually called the "Ponseti Brace."  He went from snowboard to Birkenstocks... oh well, they give him much more room to grow and are more self-adjustable on the width as well.

At 14 weeks, we still had him wearing the Ponseti brace full time, but after a 15 week checkup, he'll only have to wear it at night and we can tickle his toesies to our hearts' content all day!

Here is a video of him crawling.  He is almost 1, but he started crawling when he was 7 months old, with and without the brace on.

At 10 months old, he's still doing great and he can crawl, pull to a stand, and even tries to walk with his brace on at bedtime.  Without his brace, he loves to "drive" his push-walker all over inside and out - pretty early walking for a big boy!

Now that he's 15 months and has been walking and running for a while, he's still doing great!  His toes still point quite a bit outward, but the doctor isn't concerned.  Better to overcorrect than to have a recurrence and start back at square one! 

At 16 months, he still prefers to sleep on his side, which twists one of his feet almost backwards, but he doesn't seem to mind.  Sleeps great for 10 hours nearly every night.

At 22 months he had another checkup. He had some continuing trouble with "external hip rotation" something which made him sort of waddle when he walked or ran. It was hard to tell if it bothered Kyle, but it's something that was supposed to clear itself up after only a month or two of walking. At 20 months (8 full months of walking), we decided to take some action against it by turning the brace inward so instead of a 70 degree outward angle of his feet, we put it down to 35, almost normal position.  We brought him back to Dr. Epps two months later to make sure there was no regression. Apparently, Kyle has very flexible ligaments and tendons and he hasn't lost any of his ankle flexibility, so all was well.  We're keeping the brace at 35 degrees and continuing to monitor his flexibility and unbraced position.  He is walking significantly better without the waddle and he's a faster runner now. The more active he is on his feet, the better his chances of preventing a regression.

For Reference, here is the starting point and each successive cast's results. Quite a difference each week makes!

After 14+ weeks in the brace, still looking good with all his flexibility!

At 8 months old he was pulling up and cruising.  Still pretty wrinkled around the ankles, but no one ever notices.  Great flexibility, too.

At 22 months, walking and running as normal as can be.