Removing Ponseti Casts Without the Use of the Saw

Plaster of Paris can be removed after soaking.

Soaking can either be done as a ‘pre-soak’ by the families, or in a bath in the clinic.

Pre-soaking Casts

Try to start the pre-soak at least 1 hour before coming to clinic.

  • Put a cloth (cotton tea towel or muslin) in water to soak o It helps to fold the cloth
  • Put a dry towel under the leg in cast
  • Fill a jug/small container with warm water
  • Pour warm water very slowly onto the cast and rub all over
    • This gets the softening process started without taking it too far
    • The outside of the whole cast should be very damp
  •  Take the cloth out of the water, don’t squeeze and immediately wrap it around the
    leg in cast.
    • It needs to be really wet to work well
  • Wrap clingfilm around the cloth and cast
  • Keep it all in place by putting the leg into a bag and tie the bag around the top of the

Bathing in clinic

Fill a baby bath with warm water to cover the casts and allow the baby and casts to soak for 10-15 minutes with gentle squeezing of the casts to allow water to get between the layers

Removal of cast

Method 1: Use of the plaster knife – this is a safe method with care and time.

  • Start at the top of the leg
  • Cut at a 45 degree angle
  • Where you can, put your own fingers between the baby and the knife
  • Do not pull undercast padding away until all cast is cut
  • Continue to wet cast as you cut through to facilitate softening of plaster
  • Ease the cast material open as you go
  • The last bit around the foot can be moved with gentle wiggling

Video available on request from

Method 2: Unwinding the plaster.

  • Leave a nubbin of plaster after each roll is finished to facilitate finding the end to
    start unwinding
  • If nubbin is not available, make small cut with plaster knife to fashion an end to start