Talipes Information and Parental Support Group
TIPS Newsletter Septembet 1998
Max Whybro
by Max’s mother, Melody Whybro
I've just found this site via a bulletin board based in America! I'm from Sydney and my
three year old son Max has just had his second lot of surgery for bilateral talipes
equinovarus. He had serial plasters from birth, soft tissue release at 3 1/2 months and
then straight last shoes (the first couple of pairs with wedges built into the soles)
until h
is recent operation.
This operation was a split tibialis tendon transfer where the surgeon transferred half the
tendon at the inside front of the ankle to the tendon at the outside front of the ankle.
Max's first surgery was successful but as he got older his heels began to turn back under
and his toes started to hook back a bit. He was walking fine and could kick a football (a
Sherrin of course) better than most kids his age but we felt that we had to give his feet
the best possible chance to grow as straight as possible.
The last couple of months have been interesting, with Max unable to walk. We've hired a
wheelchair and made other accommodations but I think we worried before the surgery that he
would become a cranky little boy due to the frustration. That didn't happen. He stayed his
beautiful little self and doesn't ever complain that he can't walk.
This is a rather long way of introducing myself but I'd be very happy for parents with
younger children to ask me questions as I know how I would have loved to be able to ask
questions when Max was a baby. And if anyone else has had the split tendon transfer can I
ask you some questions? My email is mwhybro@mail.usyd.edu.au
PS. The photo of Max is at five days old after one set of casts.
Updated 5 January 1999
Max's good news -- we went to the orthopedic surgeon
today and he was very pleased with Max's progress.
He needs no further treatment, no AFOs or special shoes, and the doctor is optimistic he
will not require any further surgery. We are celebrating tonight.
Updated 10 September 2001
We had our visit with Max's orthopedic
surgeon this morning and I thought I'd send an update about his feet so you can
add it to the site, in case someone else is wondering about similar symptoms in
their child. We had brought forward Max's two-year checkup by a few months
because we were worried that his toes seemed to be turning in quite a lot,
especially when he is tired after football or running around. The doctor said
that although his feet are quite straight and the weight-bearing pattern is good
(he takes weight evenly on the front of his foot and the heel), he does have a
slight inward twist in the bones between his knee and his ankle. This is called
tibial torsion. When Max is walking normally, his hips and knees compensate for
the torsion, but when he is lying down or is tired his feet turn slightly pigeon
toed. His right foot is worse than his left by a few degrees (the left foot
turns in about 20 degrees, the right foot more like 30 degrees). Our doctor said
that, although tibial torsion is more common in children with talipes, many
children with otherwise normal feet have it as well, and most children grow out
of it. There is an operation that involves breaking and resetting the leg bones
but our doctor said he wouldn't do it before the age of about 12 and, even so,
he didn't think Max's tibial torsion was severe enough to warrant an operation.
He said this won't have any effect on Max's posture or muscle development. He
said that orthotics would not make any difference to the torsion and weren't
necessary in his opinion; Max's hips and knees are doing the job well enough and
orthotics, while they would support Max's feet when he is wearing them, don't
have any lasting effect on the torsion. I asked if they would help by giving the
muscles a rest and he agreed that they would, but said he felt the expense of
the orthotics was not really justified by any improvement at this stage. One
thing that was interesting was that he said the best shoes for Max would be
running shoes with a flared-out heel; this is because the flared heel will help
give stability on uneven ground and the cushioning effect of the runners will
protect his joints, which don't have as much "give" and cushioning as
normal. I found this interesting because Max very much prefers to wear his
school sports shoes (which are the Clarks white leather runners with velcro
straps -- very durable and not extremely expensive, so I recommend them to other
parents) than any other pair of shoes in his wardrobe. He has a nice pair of
suede boots for special occasions and a pair of pull-on blundstone-style boots
for school, plus a couple of other pairs of sneakers and sandals, but he will
almost always ask to wear his white runners. So now I know why! It also explains
why he complains more of foot pain after football -- his footy boots are quite
hard. So now we don't have to go back for a check up for another two years, when
Max will be nearly nine years old! By then, I hope he will have partly grown out
of the tibial torsion (or at least I hope it won't be any worse). We'll probably
look into orthotics, just to be sure, and make a final decision about that
later. All in all, we're feeling very relieved about the way the check up
went!