Clubfoot is one of the most common orthopaedic congenital defects, affecting approximately one in a thousand births and there are an estimated 150,000 babies born per year with the condition in the world. Although there is a genetic component, the exact cause remains unknown and the condition is prevalent in every population group worldwide.
In the distant past, club foot was often treated (and rather unsuccessfully) with extensive surgical procedures. However, more recently, a management algorithm using a simple plastering technique (the Ponsetti technique) has proven to give excellent long term results for the vast majority of children. Indeed, the technique is so effective that there is now a global campaign to improve the lives of many children throughout the world (globalclubfoot.com/) and prevent heart breaking neglected cases as seen below.
However, one of the major difficulties with the Ponsetti technique, and the occasional reason the technique does not succeed, is the commitment required to maintain the child in special boots, attached to a bar (see below), worn every night, until the child is up to 4 or 5 years old.
As an orthopaedic surgeon who has worked in a clubfoot clinic in South Africa, and taught the Ponsetti treatment in Cambodia, and met many parents with children undergoing Ponsetti treatment in the UK, I always wondered how the children tolerated their nightly brace and bars so well. Indeed I would often ask the parents how their children coped but I was always told the children seem to comply and I therefore thought nothing more of it. However, it never once crossed my mind the actual difficulties the nightly routine would be for parents putting their child to bed in braces on their feet.
I recently came upon the book “My Clever Night-Night Shoes”, inspired by the author Karen Moss, who experienced this very problem of convincing a child to wear the boots at night. Beautifully illustrated by Lori Bentley, the book is designed to act as a companion and motivator for any child who is frustrated with the night-time routine of wearing their cumbersome boots.
This elegantly rhyming and illustrated book is genuinely a perfect answer to the night time struggles I can now imagine parents often go through. The book swings through a poetry carousel of footwear options for the child to dream about, from firemen’s boots to ice skates, each illustrated with a cute animals figure, a cheeky penguin or a supportive teddy bear for example. The drawings are vibrant and enigmatic, my favourite drawings including the teddy bear sprinting on the racing track, chasing after the child, or the penguin, tip toe-ing out of the kitchen, stealing a cookie without anyone noticing.
The prose is well written, easy yet fun to read, and certainly kept me entertained, as I imagined reading it to a child. My favourite line was, “To stomp and to stride, to jump and to glide, to spin and to whirl, to tiptoe and twirl”, which is a line I would be proud to have in any one of my fictional stories. The entire book made me smile as I went through and it definitely made the boots more palatable and more exciting for anyone to wear. I genuinely felt like I needed a clever pair of night-night shoes for myself now!
I commend the author on this very novel project and it’s definitely a book I would recommend to the parents of my patients in the future, as I hope to travel forward in the realm of paediatric orthopaedic surgery. The next time I ask parents how their child is coping with the Ponsetti regime, I will certainly have more insight to the struggles, and if they do need help, I will know of some drawings that may make it all a little easier!
The book is available to purchase on Amazon and MDOrthopaedics:
