The Casting Stage for Congenital Talipes Equinovarus, also known as clubfoot or talipes.

Treatment should ideally begin in the first six weeks of life to take advantage of the elasticity of the ligaments and tendons.

With the impact of COVID some babies have had their treatment delayed, however successful Ponseti Management of babies over 3 months is possible.

The Ponseti Method requires a minimum of 2 trained practitioners. If your baby is older than 3 months, one practitioner should have experience in managing treatment for babies over that age.

Manipulation and casting of the foot are done very gently so should not hurt your baby.

Plaster casts are the best material for making Ponseti casts. Ponseti casts are long leg casts. They should be over the knee (from toe to groin) and well moulded onto the foot.

For newborns, only about 5-7 casts should be required to achieve correction. Your baby may need few less, this will depend on the severity of the condition.

Casts should be removed just before the appointment. Your treatment team will provide you with the necessary guidance.

If there is a lack of progress of correction after 7 casts, your treatment team should sought advice from a high volume specialist Ponseti service.

Sometimes an overwrap is used to reinforce the cast in older children or if the casts might need to be removed at home. However the under layer should always be Plaster of Paris to allow for the cast to be correctly moulded.

Useful Advice:
• Take a photograph of the positioning of the toes within the cast and the skin around the edges of the cast before leaving the treatment room. It will help you to communicate with your treating team in case of issues with the cast.
• Ask your treating team to show you how to check the circulation in your baby’s toes.
• It takes several hours for the cast to dry fully. During this time, please leave the cast exposed as it will dry quicker.
• Change your child’s nappy more frequently to avoid soiling the plaster.
• Check the skin around the edge of the cast for any signs of redness or soreness.

• It is important to contact your treating team if;
o Your child’s toes have slipped into the cast as this indicates that the plaster has slipped and will not longer be correcting the feet
o Your baby’s toes have changed in size or appearance
o The plaster becomes loose, cracked, crumbly or very wet.