I've seen a number of posts here about serial casting but just thought I'd start a new one again.  I am looking into the casting for my son Kevin.  Here is a little history:


He is ambulatory but broke his ankle (non-displaced fracture of the distal tibia) in early Sept., the bone healed and he was back on his feet by mid-November and walking pretty good by mid-Dec.  He was doing well until he took a tumble on Christmas Day at his aunt's house on some carpeting. Nothing broke but his knee was sprained.  He was off his feet again for a bit but he is able to walk now but not a real long time and he is walking on tippy toes now (not real high) because everything is now tighter.   We had an evaluation (where my friend Jen G's son Danny had his done) and they thought he would be a candidate for the casting. 


I've checked with one of his physiatrists (we see docs in NYC and Cincinnati) and she is not sure if Kevin is a candidate saying that some boys who are losing strength tend to walk on tippy toes to compensate.  And that the casting could make the situation worse.  I have to speak more with her but while he can't get up from the flooor he is pretty strong in other areas.  I just feel the tippy toes is the result of the repercussions from the fall and that if he could get his heels back down a bit he would walk better.  I'm in a quandry as to what to do.  We will visit another of his physiatrists this week to discuss this further and then talk to his neurologists. 


Has anyone had a similar dilemma?  I would love some input before going forward.  We were thinking of doing it Easter vacation week.


Thanks all.


Patti Frank

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My personal opinion is that it would be beneficial. My son had serial casting done two summers ago, he was 16 at the time and I am glad we did it, the results were well worth the hassle. If he is indeed walking on his toes for balance I can't see how giving him more range of motion would change that, he would still be able to do that. I would think that better range of motion, heel cords that aren't so tight would always be a good thing. Jonathan has lost almost all the range he got from the casting because he refused to wear his night afos or stretch afterward, but when they're that age what can you do?

Thanks Susan. Most people say it is beneficial. I appreciate your input and have seen your posts on here previously. I used to be on the old discussion forum more but am on Facebook alot and keep forgetting to come here. The docs in Cinncy ae the experts and that is why I queried them, but I want to talk to the physiatrist out there a little more to understand the "why" of how it could possibly make things worse. But up to his ankle break my son was getting around just fine, albeit not walking fast or running and occasionally falling on the baseball field -- so I'm not sure how it could be harmful.... but we will see. Tomorrow he sees his physiatrist here in NJ to do with a matter for school -- they wanted an updated guideline for Kevin at school. I will see what she thinks also. I'm just so stressed about this and my son has been so upset lately. I just feel it is too early to assume he won't walk. I need to know what the alternative approach would be to help him if he doesn't do the casting. How to we make it better. Thanks. I'll update again when I find out more.

Patti-- we are casting my 8 yr old son tomorrow. We saw dr. wong for the 1st time in Feb and she thought it would benefit him (Philly drs. had said the same thing last yr, but my son gets around fine, and we didn't want to put him through it yet). Dr. wong only casts for 10 days, so we figured it couldn't be that bad. My son has always walked a little on his toes, and his range of motion is pretty bad in his ankles. Since he has always walked that way, I guess he compensated for the poor range of motion. Dr. Wong said she thought he would be helped by the increased range of motion since his strength is relatively good. I will be curious to see if the better motion in his ankles will improve how he gets around. I'll know by 4/15, so I can let you know.

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