Q. A baby undergoing corrective casting for the correction of clubfoot has been applied 13 plasters but correction doesn't seem to improve lately and there is swelling of foot on each cast removal. The parents also complain of slipping of the cast noticeable for last few occasions. Which among these would be best option to treat such case?
a. Modification of casting technique
b. Apply loose plaster next time
c. Apply more pressure on casting for speedy correction
d. Do not apply cast
e. Prepare the child for surgical correction
Answer -
d
Slippage of cast and static correction with swollen and often painful foot suggests 'atypical clubfoot'.
The loose and improperly moulded cast leads to slipping of feet inside and that impinges over toes leading to swelling and pain. Thus loose plaster or extra pressure won't help here (option b and c).
Modification of casting is not acceptable as casting follows standard prescribed methodology.
Surgical option is not required for correction in most cases and is limited for certain indications only.
Leaving foot free without cast for 6-8 weeks or till swelling and edema is reduced ( i.e. cast holiday) is best option.
Casting is resumed after abovementioned status is achieved.
a. Modification of casting technique
b. Apply loose plaster next time
c. Apply more pressure on casting for speedy correction
d. Do not apply cast
e. Prepare the child for surgical correction
Answer -
d
Slippage of cast and static correction with swollen and often painful foot suggests 'atypical clubfoot'.
The loose and improperly moulded cast leads to slipping of feet inside and that impinges over toes leading to swelling and pain. Thus loose plaster or extra pressure won't help here (option b and c).
Modification of casting is not acceptable as casting follows standard prescribed methodology.
Surgical option is not required for correction in most cases and is limited for certain indications only.
Leaving foot free without cast for 6-8 weeks or till swelling and edema is reduced ( i.e. cast holiday) is best option.
Casting is resumed after abovementioned status is achieved.
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