והנה תשובה מ Joy Markell
האיש שעושה את הנעליים של Markell בארה"ב
Historically, the reverse last boots have been used to maintain correction after casting. The open-toe reverse last boot that we make provides about 8 degrees of abduction or outflare in the forefoot. Dr Ponseti used this shoe as a means of maintaining correction on the Denis Browne Bar, years ago, prior to his evolving the treatment to today's standard. Back then I believe he was not correcting the feet out to 70 degrees external, or that after casting he was not holding the feet on the DBB at 70. In that situation the outflare of the shoe helped to turn the foot out beyond what the bar was doing. Now, today, since it was found that 70 degrees of external rotation on the clubfoot(feet) can be tolerated and is more effective in maintaining correction and preventing relapse, Dr. Ponseti and others no longer find the need to use the outflare open-toe boot. They switched to the straight last boot. Some Docs still use reverse last boots. It is not a bad thing. Some might say that it is overkill, or perhaps a "belt and suspenders" approach. I hope this clarifies things a little for you.
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