Treatment for Clubfoot: Stockinette Versus Webril Cast Padding in the Ponseti Method

Area of Science:

• Orthopaedic surgery
• Pediatric orthopaedics
• Congenital deformities

Background:

• Clubfoot is a common congenital condition treated with the Ponseti method.
• The Ponseti method involves serial manipulation and casting.
• The impact of different undercast padding materials on treatment outcomes has not been previously studied.

Purpose of the Study:

• To compare the effectiveness of cotton Stockinette versus Webril undercast padding in Ponseti method treatment for idiopathic clubfoot.
• To evaluate the number of casts required, clinical outcomes, and adverse events associated with each padding type.

Main Methods:

• A randomized controlled trial was conducted with 56 infants under 6 months with untreated idiopathic clubfoot.
• Patients were randomized to receive either double-layer Stockinette or 2- to 3-layer Webril padding during casting.
• Outcomes measured included the number of casts, Pirani and Dimeglio scores, and adverse events.

Main Results:

• No significant difference was found in the mean number of casts required for correction between the Stockinette and Webril groups (approximately 4 casts).
• Both groups showed similar improvements in clubfoot deformity as measured by Pirani and Dimeglio scores.
• The incidence of skin complications was comparable between the two padding groups, with no statistically significant difference.

Conclusions:

• Cotton Stockinette and Webril undercast padding yield equivalent results in clubfoot correction via the Ponseti method.
• The number of casts needed and complication rates are similar regardless of padding material used.
• Stockinette padding was subjectively preferred by parents and clinicians.