A plaster cast is applied after each weekly stretching session to retain the degree of correction obtained and to help soften the ligaments.
Thereby, the displaced bones are gradually brought into the correct alignment.
Five to seven plaster casts, extending from the toes to the upper thigh with the knees maintained at a right angle, should be sufficient to correct most clubfoot deformities. Even the very stiff feet described above require no more than 8 or 9 plaster casts to obtain maximum correction. Before applying the last plaster cast, which is to be worn for three weeks, the Achilles tendon is often cut in an office procedure to complete the correction of the foot.
By the time the final cast is removed, the tendon has regenerated to the proper length. After two months of treatment, the foot should appear overcorrected, as the tissues have a tendency to move back towards their former position after treatment is finished. Recently we found that the treatment can be shortened by changing the plaster casts every five days instead of every seven days.