Treatment of severe clubfoot with manipulation using synthetic cast material and a foam-casting platform: a preliminary report

Journal of Pediatric Orthopedics. Part B
Bobby Kin-Wah NgJack Chun-Yiu Cheng

Abstract

Conservative clubfoot treatment requires weekly cast changes. We questioned whether a method using synthetic fiberglass instead of the traditional plaster material and with the infant lying comfortably on a special foam-casting platform could be satisfactorily used. A retrospective cohort review on idiopathic clubfoot treated with this particular method was carried out. The severity of clubfoot at presentation was assessed with the classification of Dimeglio et al. The outcome of treatment was assessed with the same scoring system at the latest follow-up. The need of secondary open surgical releases was noted. The parent's acceptability of this method was evaluated with a self-designed questionnaire. The existence of a learning curve was explored by comparing the outcomes of 22 feet during two time periods: those treated before 31 December 2003 (group 1) and those treated after 1 January 2004 (group 2). The mean Dimeglio Scores improved from 17.5 to 4.1 for group 1 and from 15.0 to 3.2 for group 2. Nine of 10 feet in group 2 had tenotomy of the tendo Achilles and none needed open surgical release whereas 10 out of 12 feet in group 1 required open releases. A learning curve did exist for this method. No major complication was no...Continue Reading

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Citations

Dec 15, 2010·Current Opinion in Pediatrics·Harold J P van Bosse
May 3, 2013·Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine·Tamara L CohenGerald F Harris
Dec 4, 2015·Medicine·Bahattin Kerem AydinYunus Kirac
Sep 14, 2011·The Journal of Bone and Joint Surgery. British Volume·C R JowettM Ramachandran

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