Steenbeek Brace: Patterns of Wear.

UNLABELLED: Steenbeek foot abduction brace (SFAB) is an essential orthotic for maintaining correction in congenital talipes equinovarus treated with Ponseti method. As the brace is used up to 3 to 4 years of age, we examined the brace wear pattern according to a child's development and age. We studied 100 SFABs that were rendered unusable or returned by parents due to advanced brace wear. SFABs returned due to other reasons such as foot outgrowing shoe size were excluded. Each part of the brace (outer sole, insole, upper leather, abduction bar, shoe laces) was carefully inspected to observe any pattern of damage. We grouped the pattern of brace wear as per the probable causative factors into 3 broad categories: due to general use in all age groups, sitters and crawlers, and walking children. Shredded tongue, elongated/torn shoelace hole, peeled paint of metal abduction bar, shredded outer sole, and frayed shoelace were due to general use. Due to sitting and crawling with the brace on, shoe wore on its anteromedial, anterolateral, and posterolateral parts at the junction of the upper leather and outer sole. The commonest area of shoe wear in walkers was the abduction bar, which either broke from the welded junction between bar and metal or was bent at midpoint. The SFAB wear pattern was related to the age of the child and his/her activities. The reusability of the brace can probably be extended with simple improvisations and instructing parents about the correct use of the brace.

LEVELS OF EVIDENCE: Prognostic, Level IV: Case series.