Ponseti boots and bar

Ponseti boots and bar (a foot abduction brace) are special shoes connected by a bar that holds your child’s feet in position. This keeps muscles and ligaments stretched after correction with plaster casts.

We most often use the Mitchell boots and bar, though other systems are also available.

Your orthopaedic team prescribes the brace, and your orthotist will ensure a safe and proper fit.

After casting, clubfoot can quickly tighten again. The boots and bar:

• Hold the corrected position
• Prevent re-tightening
• Greatly reduce risk of relapse

Without consistent wear, further casting or surgery may be needed.

Your specialist will guide wear times, but typically:

• First 3 months: 23 hours a day (off only for bathing or dressing)
• After 3 months: Worn during naps and overnight, often up to age 4–5

This ongoing phase is still vital, even if your child is active and settled.

• Use socks (Ponseti socks may help with sensitive skin)
• Push heel to the back and base of boot
• Fasten ankle straps snugly while holding heel down
• Secure toe and shin straps (if used)
• Check heel position through viewing holes
• Attach boots to the bar

Important: The heel must stay fully down. If it lifts, the Achilles tendon may tighten again.

• Remove only for approved breaks (like bathing)
• Reapply carefully, checking heel each time
• Don’t adjust bar angles unless advised by your clinician

Check skin daily, especially:

• Heels
• Ankles
• Tops of feet
• Behind knees

Watch for:

• Redness that doesn’t fade
• Rubbing or blisters
• Toes sliding back (heel may be lifting)