In order for the Ponseti method to be successful it is essential that the casting process is carried out correctly.  Casting materials you will need are: a thin layer of cotton padding and plaster of Paris.  You may need to experiment with different types of materials in order to find the ones that work best.  For example: if the padding is too thick the foot will be difficult to feel and manipulate and the cast will not hold it in the corrected position well.  If the plaster does not set quickly enough it may again be difficult to hold the corrected position and if it is too heavy it can slide down the leg, applying pressure in the wrong places and sometimes causing skin ulcers.

Under cast padding

Picture: examples of under cast padding. The one on the left is cheaper but very difficult to use while the one on the right is thinner and wraps around the leg more easily.

Please refer to the Global HELP manual for full details of how to carry out the casting.

Some people have attempted correct clubfoot using half-leg casts (up to the knee).  These are not effective as they do not hold the lower limb well.