HOW DO THEY WORK
The boots and bar are positioned to have a similar position of the foot to the casting position.
This has 3 parts:
1. Toes turned outwards (See Figure. 1)
2. Feet tilted inwards (See Figure. 2)
3. Ankles held at 90 degrees (See Figure. 3)

USING THE BOOTS
How Long Should They Be Worn?
The boots and bar will be fitted within a few days of or on the day the last cast was removed. Initially, you will need to let your child gradually get accustomed to wearing the boots and bar.
Boots and bar should be worn 23 hours a day. Over the first week you should leave them on for periods of time and gradually increase these periods until they are on for 23 hours a day.
For example:
Day One 1 hour on, then 1 hour off
Day Two 2 hours on, then 1 hour off
Day Three 3 hours on, then 1 hour off

If your child is not having problems tolerating them, it is fine to speed up this process.

When Should They Be Removed?
The boots and bar should be removed for bathing. If you wish, you may remove them before bath time or leave them off for a little while after bath time.
Some parents prefer to give their child 2, 1/2 hour breaks during the day. Either method is acceptable.
Enjoy this time massaging and stretching your child’s feet and let them have a good kick.

How Often Are They Checked?
In most cases your Orthopaedic Surgeon will initially review your child every 2 weeks and then monthly.
The Orthotist is available at these appointments for adjustments or to answer questions.

Removal Of Boots & Bar
The total period of time your child will wear the boots and bar will depend on their feet and their progress. These decisions will be made by your Orthopaedic Surgeon.

APPLICATION
There are a couple of options and you can choose whatever is easiest for you. The Orthotist will show you how to put them on and take them off when they initially fit the boots and bar.

1. Keep the boots attached to the bar and put the feet in one at a time (often the worst foot first is easiest)
2.Remove one boot from the bar and put both boots on and then attached the single boot to the bar.
3.Remove both boots and put them on and then attach the bar last.

Some key points to remember when putting them on:
1. Make sure the heel is right down into the back of the boots.
2.Do the single ankle strap up firmly over the foot and through the lower slot to hold their heel into the boot.
3. Lace-up boot firmly.

My Child Has Red Marks On Their Feet
It is common to notice red marks appear on your child’s feet when you remove the boots and bar. This is normal and expected. These red marks should fade within 20-30 minutes of removing the boots and bar. These often settle as your child settles into wearing the boots and bar.

What Do We Do If The Red Marks Stay?
If red marks do not fade they may be areas where blisters may occur and these are often at the back of the heel. Make sure that there are no wrinkles in socks and the ankle strap is firm so that your child’s heel cannot ride up inside the boot. If these measures are not successful, contact the Orthotist immediately.

What Happens When The Child’s Feet Grow?
When your child’s feet grow it is your responsibility to pay for all replacement boots.
The same bar is used throughout the treatment.
Normally the boots will fit for approximately 4 months but this varies depending on how quickly their feet grow and how long the treatment is needed.

Conclusion
We hope this has answered your questions regarding this part of the treatment.
If you have any further questions, please feel free to contact your Orthotist.