PT  - JOURNAL ARTICLE
AU  - Catherine Hui
AU  - Elaine Joughin
AU  - Alberto Nettel-Aguirre
AU  - Simon Goldstein
AU  - James Harder
AU  - Gerhard Kiefer
AU  - David Parsons
AU  - Carmen Brauer
AU  - Jason Howard
TI  - Comparison of cast materials for the treatment of congenital idiopathic clubfoot using the Ponseti method: a prospective randomized controlled trial
AID  - 10.1503/cjs.025613
DP  - 2014 Aug 01
TA  - Canadian Journal of Surgery
PG  - 247--253
VI  - 57
IP  - 4
4099  - http://canjsurg.ca/content/57/4/247.short
4100  - http://canjsurg.ca/content/57/4/247.full
SO  - CAN J SURG2014 Aug 01; 57
AB  - Background: The Ponseti method of congenital idiopathic clubfoot correction has traditionally specified plaster of Paris (POP) as the cast material of choice; however, there are negative aspects to using POP. We sought to determine the influence of cast material (POP v. semirigid fibreglass [SRF]) on clubfoot correction using the Ponseti method.Methods: Patients were randomized to POP or SRF before undergoing the Ponseti method. The primary outcome measure was the number of casts required for clubfoot correction. Secondary outcome measures included the number of casts by severity, ease of cast removal, need for Achilles tenotomy, brace compliance, deformity relapse, need for repeat casting and need for ancillary surgical procedures.Results: We enrolled 30 patients: 12 randomized to POP and 18 to SRF. There was no difference in the number of casts required for clubfoot correction between the groups (p = 0.13). According to parents, removal of POP was more difficult (p < 0.001), more time consuming (p < 0.001) and required more than 1 method (p < 0.001). At a final follow-up of 30.8 months, the mean times to deformity relapse requiring repeat casting, surgery or both were 18.7 and 16.4 months for the SRF and POP groups, respectively.Conclusion: There was no significant difference in the number of casts required for correction of clubfoot between the 2 materials, but SRF resulted in a more favourable parental experience, which cannot be ignored as it may have a positive impact on psychological well-being despite the increased cost associated.