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The illustration accompanying this clinical note indicates a modification of the technic of the application of plaster-of-paris casts used in the treatment of clubfoot. In addition to the routine application of casts, one applies a crossbar of plaster with a foundation consisting of two wooden tongue depressors cut to the required length. One tongue depressor is placed over and the other under the completed casts at a point about 1 inch (2.5 cm.) above the internal malleolus.
A few turns of plaster bandage are then applied, making a solid but very light crossbar connection. This may be used to hold the legs in any position of external rotation which is usually desirable. It is noteworthy that after treatment and correction of clubfoot there often remains an inward rotation of the lower legs or entire lower extremities which causes disability and a visible deformity.
Lewin P. IMPROVED TECHNIC IN THE APPLICATION OF PLASTER-OF-PARIS CASTS IN THE TREATMENT OF CONGENITAL CLUBFOOT. JAMA. 1928;90(24):1943. doi:10.1001/jama.1928.92690510001010