The Denis-Browne Bar is a device attached to the bottom of the child’s shoes and worn at night The splint consists of a spreader bar and two metal plates or brackets to which shoes are attached.
The shoe plates can be attached in two ways, i.e. fastened to the bar with a clamp to the side of the shoe, or screwed into the bottom of the shoe. Either method allows loosening to position the feet in as much internal or external rotation as the physician deems necessary.
In treatment for rotation deformities, the length of the bar should not exceed the width of the pelvis. The major drawback is compliance by the child and the ability to adapt to sleeping with the splint in place.
§ Internal Tibial Torsion
§ Club Foot
Follow your physician’s instructions as to wearing protocol. Normally, the child wears the bar at night for approximately 6 to 12 months.
DON AND DOFF
§ Do not remove shoe from bar.
§ Place the child’s foot in the shoe with the knee bent.
§ Tie the shoe snuggly to keep the foot firmly in the shoe.
§ Clean socks are a must. The child is in the shoes during the day and also all night. Changing of socks will help prevent odor and onset of any dermatological problems.
§ Powder in shoes and socks will help to don and doff shoes and prevent problems.
§ Cover the bar with some type of soft material to keep from tearing sheets.
§ Use toggle to keep child from untying shoes. Try not to use Velcro closure shoes as the child can undo the Velcro and remove at night.