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Proposal of an innovative casting technique for correction of clubfoot according to Ponseti method

a pilot study

Gigante, Cosimoa; Pedrotti, Luisellab; Guido, Davidec

Journal of Pediatric Orthopaedics B: May 2019 - Volume 28 - Issue 3 - p 242–247
doi: 10.1097/BPB.0000000000000539

A total of 70 clubfeet were treated by a posterior above-knee cast (pressure points on the talus and on the first metatarsal) according to Ponseti method. At diagnosis, average Pirani score was 4.44, and mean time of treatment was 50.32 days. Overall, 27 (38.6%) clubfeet had only conservative treatment (5.29 casts) and 43 (61.4%) also had Achilles tenotomy (6.38 casts). At the end 61/70 feet (87.14%) had Pirani score 0; 10/70 feet (5.71%) had Pirani score 0.5. The Pirani score gain/cast was β=–0.432 (P<0.001). This new casting technique is safe and effective at avoiding some adverse issues related to the removal of the conventional cast.

aDepartment of Woman and Child Health, Pediatric Orthopaedic Unit, Padua General Hospital, Padua

bSurgical, Diagnostic and Pediatric Department, Musculoskeletal System Diseases Unit, University of Pavia, Clinical Sciences, Pavia

cNeurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy

Correspondence to Cosimo Gigante, MD, Pediatric Orthopaedic Unit, Padua General Hospital, via Giustiniani 3, 35127 Padova, Italy Tel: +39 049 8213330; fax: +39 049 8211794; e-mail:

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