The effect of a change in plastering technique on the rate of Major Surgery in Congenital Talipes Equinovarus(CTEV)

The Ponseti technique of manipulation and casting is reported to have almost eliminated the need for extensive soft tissue release in the treatment of idiopathic clubfoot. This technique of treatment has however not been universally adopted and results of treatment vary significantly between treatment centres. Furthermore, surgical decision making in the treatment of clubfoot is currently largely based on clinical findings as opposed to radiographic parameters. The Ponseti method of manipulation and casting was introduced at our institution in 2002, prior to which we used the Kite method. Both prior to, and following the introduction of Ponseti casting, surgical decision making was based on pre-operative radiology, and intra-operative clinical assessment. We propose to determine the impact on this change of plastering technique on the rate of major surgery performed primarily in our patients with idiopathic clubfoot. We also aim to determine whether or not pre- operative radiographs have any bearing on the surgery performed on these patients