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======================================== Anterior Tibial Tendon Transfer. It's a surgical procedure where they detach the big tendon that runs down the front of your ankle, and reattach it to another bone that's more towards the outside of his foot. The tendon holds the foot in correct alignment. Jake will be in a cast for 6 wks, and that should be the end of his clubfoot treatment!! According to our surgeon, relapse after this surgery is extremely rare. Kassia mommy to Jacob 3/22/01 (Lt clubfoot, ATTT surg 4/27/04) and Emily 11/22/02 ================================================= Cori-- I'm sorry your son will need that surgery- that will be hard, having him in a cast all summer. I hope everything goes well for both him and you!! Will he need any further treatment afterwards? Jake is doing great, thanks for asking! We're down to giving him pain medication just 3 times a day now (in the morning, before nap, and before bed)...he never really seems uncomfortable anymore. He gets around great. It's amazing how well he's adjusted to having the cast! He crawls around (really fast) and can do stairs. He has tried to walk with it a few times already, but we're trying to discourage that (technically he's supposed to stay off it for the entire 6 wks, but I don't know how I'd pull that off, other than tying him down LOL!). Our main problem thus far is his frustration with the things he can't do. He got seriously pissed at me when we went to the grocery store, because I wouldn't let him crawl around and made him ride in the cart. He's also sad about not being able to go to the park (I don't want him crawling around in woodchips) and not being able to crawl around outside. Already he's starting to wear thru the fiberglass outerwrap at the knee area...can you imagine how fast it would wear thru if he was crawling on cement?? He's also upset about not being able to have a bath. Jake's cast will be coming off June 9...I can't wait for that day!! We have a calendar hung in Jake's room and we're planning on doing a countdown for him. Good luck with your son's treatment--I hope all goes well for you! Kassia mommy to Jacob 3/22/01 (Lt clubfoot, ATTT surg 4/27/04) and Emily 11/22/02 ============================================​

Martin, Thank you for the info. That was the surgery I thought my son was going to need. But instead he is having the supramalleolar tibial osteotomy. It would be nice to abbreviate that. STO. (LOL) My son has had the posteromedial release at 11 months. Even though the article says the ATTT is minimal compared it sounds worse. Thanks again. Cori Joseph 7.2.97 Unilateral left clubfoot --- In [email protected], "Martin Egbert" <martinegbert@e...> wrote: > Cori, > > An ATTT is an Anterior Tibial Tendon Transfer. It is a surgery that > can be done when there is a relapse and a child is over 2 years of > age. It takes the tendon that runs down the top of the foot that > attaches to bones that attach to the big toe and moves it's > connection over to bones that attach to the 3rd toe. > > There is a couple of pages of photos and description of an ATTT that > can be seen at the Global HELP web site. > > "When the deformity relapses, further weekly manipulations are > performed and plaster casts are applied. Occasionally, another > percutaneous Achilles tenotomy may need to be performed. In some > cases, despite proper bracing, a simple operation may be needed when > the child is older than 2 years to prevent further relapses. The > operation consists of transferring the anterior tibialis tendon to > the third cuneiform." > http://www.global-help.org/publications/pubclubfoot.html > > The ATTT is done by Ponseti method doctors and some others after > repeated relapses that can't be fully corrected by just recasting. > In many other treatment methods, relapses would be treated with some > form of a release type of surgery. Dr. David Feldman of NYU said of > the ATTT "This surgery (ATTT) is minimal compared to the typical > surgery done currently (Posterior release types)." > > Martin and Joshua (3-17-99)​