title: Comparison of cast materials for the treatment of congenital idiopathic clubfoot using the Ponseti method: a prospective randomized controlled trial.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors: The Division of Orthopaedic Surgery, Department of Surgery, University of Alberta, Edmonton, Alta.
authors: Catherine
authors: C
authors: Hui
authors: The Division of Orthopaedic Surgery, Department of Surgery, Alberta Children's Hospital, Calgary, Alta.
authors: Elaine
authors: E
authors: Joughin
authors: The Departments of Paediatrics and Community Health Sciences, Alberta Children's Hospital, Calgary, Alta.
authors: Alberto
authors: A
authors: Nettel-Aguirre
authors: The Division of Orthopaedic Surgery, Department of Surgery, Alberta Children's Hospital, Calgary, Alta.
authors: Simon
authors: S
authors: Goldstein
authors: The Division of Orthopaedic Surgery, Department of Surgery, Alberta Children's Hospital, Calgary, Alta.
authors: James
authors: J
authors: Harder
authors: The Division of Orthopaedic Surgery, Department of Surgery, Alberta Children's Hospital, Calgary, Alta.
authors: Gerhard
authors: G
authors: Kiefer
authors: The Division of Orthopaedic Surgery, Department of Surgery, Alberta Children's Hospital, Calgary, Alta.
authors: David
authors: D
authors: Parsons
authors: The Division of Orthopaedic Surgery, Department of Surgery, Alberta Children's Hospital, Calgary, Alta.
authors: Carmen
authors: C
authors: Brauer
authors: The Division of Orthopaedic Surgery, Department of Surgery, Sidra Medical and Research Center, Doha, Qatar.
authors: Jason
authors: J
authors: Howard
mesh_terms: D002133:Calcium Sulfate; D002370:Casts, Surgical; D003025:Clubfoot / Q000628:therapy*; D005500:Follow-Up Studies; D005898:Glass; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019637:Orthopedic Procedures / Q000295:instrumentation* / Q000379:methods; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: C009753:fiberglass; D002133:Calcium Sulfate