The Power of Plaster
Serial casting is widely accepted as the preferred treatment option for the management of infantile clubfoot. Surgical release of pediatric foot deformities is associated with a risk of osteonecrosis, growth disturbance, overcorrection, limited range of motion, early degenerative joint disease, and pain as early as the teenage years. Compared with surgical management of clubfoot, serial casting is associated with the advantage of maintained foot flexibility. The indications for serial casting can be applied more widely to various foot and ankle deformities, such as those in older children with unmanaged clubfoot, recurrent clubfoot after posteromedial release, idiopathic or posttraumatic equinus contracture, and flexible cavovarus foot deformities. Serial casting in combination with minimal soft-tissue surgery, may delay, minimize, or eliminate the need for more extensive surgery.