How to measure the clubfoot properly?

Choosing the correct boot/shoe size for the brace is not straightforward. However, to select the right size, it is important to keep in mind several key factors — without them, the size selection is prone to significant error. This is especially important when choosing Mitchell boots.

BEFORE OR AFTER?

The foot is measured by the doctor immediately before the percutaneous tenotomy, and an appropriate allowance must be considered, taking into account:

• the natural stretching of the foot that occurs as a result of the tenotomy — when the Achilles tendon “releases” and the foot can achieve full range of motion, the tendons on the sole of the foot also stretch. Of course, the foot will continue to stretch over the following 3 or 4 weeks while in the cast, but the initial change is quite significant
• the cast applied for 3 or 4 weeks (or sometimes 2+2 weeks, or 1+2 weeks), during which it is natural for the foot to grow slightly and straighten even more.

There is one more moment when the foot can be measured — and this can also be done by you: when the cast needs to be changed after the tenotomy.

HOW?

The foot is measured from the heel to the longest toe – typically, it is the big toe, but in some cases it may be an ATYPICAL/ COMPLEX CLUBFOOT, where the first toe is in hyperextension and therefore shorter. In such cases, the measurement should be taken from the heel to the longest toe. The foot is also measured at its widest point.

WHAT DO YOU NEED TO REMEMBER?

• The foot must be measured without a cast, because otherwise it’s impossible to know how thick the cast layer is – and therefore what the real size of the foot is.
• The measurement should be taken without weight-bearing, meaning the foot should be relaxed: the child can lie down or sit, but should not stand.
• The doctor/ assistance/ orthotic should be asked to measure the foot exactly as shown in the illustration below.
• If both feet are affected, a difference in length between them may occur – so it’s essential to measure both feet.
• For unilateral clubfoot, both feet must also be measured: the affected foot and the healthy one.
• There’s no shortcut like “measure the healthy foot and subtract half a centimeter.”
  No! Our experience has shown that this approach doesn’t work – it often leads to choosing the wrong shoe size.
• You can use special Mitchell shoe measurement insoles for this purpose.

CHOOSING THE RIGHT SHOE SIZE IS NOT SO OBVIOUS
AND IF IN DOUBT, CONTACT US 🙂

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