University Hospital Southampton NHS Foundation Trust

Meet the patients: James Boorah

James Boorah

Baby James Boorah is all smiles despite his traumatic start in life. Now four months old, he has been completely unfazed by having to wear a series of plaster casts and, more recently, a pair of special boots.

Without these, he would have faced surgery to correct his club foot. Luckily for James and his parents, Simon and Amanda, Southampton General is one of a handful of hospitals in the UK to use the non-operative Ponseti method.

James was born four weeks early in Portsmouth. He was very poorly and Simon and Amanda feared they might lose him, after ten years of trying for a baby.

Amanda said: “When we were told he had fixed talipes we didn’t know what that meant, but his left foot was completely turned in. Then we found out it’s what is better known as club foot.”

Simon said: “We were concerned about him not being able to walk. The fact that my son might not be able to run or play football and other sports was at the back of my mind.”

Within two weeks of his birth, James had an appointment with consultant orthopaedic surgeon Mike Uglow at Southampton General Hospital.

Amanda said: “Straight away, Mr Uglow and Julia Judd the nurse, put our minds at rest, explaining the Ponseti method to us and putting the first plaster cast on James’ leg.”

For the next six weeks, Amanda and Simon took James to the clinic at Southampton General every week, to have his cast replaced. Each cast was a slightly different shape, to gradually stretch his foot, manipulate the bones and soften the tight  tissues.

After six weeks he had a minor procedure called an Achilles tenotomy, where his Achilles tendon was cut, under local anaesthetic. This brought his heel into place and he then wore his final plaster cast for three weeks.

Now James wears special boots that are connected by a bar, to hold his feet in  position. He will have to wear these for 23 hours a day for three to four months, and then at night and nap times until he is three or four years old.

Amanda said: “James has been brilliant, the casts didn’t bother him at all. We could see the difference it was making from very early on.”

They also found the clinic setting really helpful, meeting other parents each week who were at different stages of the treatment. They have been able to see how James’ treatment is likely to develop, as well as sharing their own experiences with newer parents.

Amanda said: “We have been so impressed with the hospital; it is a really nice place to come to, very friendly and relaxed. I have a lot of confidence in Mr Uglow.” 

Mr Uglow said: “The Ponseti method has reduced the incidence of surgery in babies with clubfeet from 80% to 5% in the initial management stage. The long term foot function is usually very good and any surgery that is required is less than would have been required without using the Ponseti method. The look on the parents’ face when the final cast is removed is worth it every time!”

This story was first published in Connect magazine.