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The Power of Plaster

February 19, 2016

Contributors: Kathryn Suzanne Doughty, MD; Kathryn Suzanne Doughty, MD

Serial casting is widely accepted as the gold standard treatment for infantile clubfeet. Surgical release of pediatric foot deformities carries the risk of avascular necrosis, growth disturbance, over-correction, limited range of motion, early degenerative joint disease, and pain as early as the teenage years. Compared to surgical treatment of clubfeet, serial casting has the overwhelming advantage of maintaining foot flexibility. The indications for serial casting can be applied much more widely - beyond infants with clubfeet - to include a variety of foot and ankle deformities, such as older children with untreated clubfeet, recurrent clubfeet after posteromedial releases, idiopathic or posttraumatic equinus contracture, and even flexible cavovarus foot deformities. Serial casting, in conjunction with minimal soft tissue surgery, may delay, minimize, or even eliminate the need for more extensive surgery.

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