Treatment of Clubfoot With the Ponseti Method

Abstract

Level II. Nonblinded randomized controlled prospective study.

Update on Clubfoot: Etiology and Treatment

“…Though Ponseti advocates the use of plaster for the cast material as it is easier to mold, there are reports on the successful use of fiberglass materials for achieving clubfoot correction [15,53]. Regardless of the casting material used, the casts are changed every 5 to 7 days [48].…”

Comparison of cast materials for the treatment of congenital idiopathic clubfoot using the Ponseti method: a prospective randomized controlled trial

“…31 This situation might be further exacerbated by difficulties with cast handling and removal. Interestingly, in the study by Pittner and colleagues, 30 there was no difference in parental satisfaction between the 2 casting groups. Further study using validated questionnaires is required to definitively answer the question relating psychological well-being to ease of cast removal and the relative importance of a parental preference in clubfoot casting material.…”

“…Since the commencement of the present study, Pittner and colleagues 30 have reported the results of the first randomized trial comparing POP to SRF. As in the present study, there was no significant difference in the mean number of casts required for Ponseti correction between the 2 groups (6.1 in the SRF group v. 5.2 in the POP group, p = 0.20).…”

“…They did, however, note a statistically significant difference in the final severity scores (according to the Dimeglio system) post-Ponseti casting, with the SRF and POP groups each having residual scores of 6.4 (moderate) and 4.1 (benign), respectively. 30 This suggests incomplete clubfoot correction on average (at least for the SRF group). As such, it is unclear whether further casting would have reduced the deformity to a more benign Dimeglio score, in turn increasing the number of casts to final correction even further.…”

Creep evaluation of (orthotic) cast materials during simulated clubfoot correction

“…1,2,3,4,5 Casting with plaster-of-Paris has been the historical standard for clubfoot immobilization since it was introduced by Guerin. 1,4,6 Traditionally, plaster-of-Paris has been long praised for its moldability and patient comfort for serial casting purposes. On the other hand, it can be heavy, takes a long time to dry completely, and requires soaking for several hours or a cast saw to remove it, risking skin injury.…”