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Table 1 Level 2 evidence and the development of the ‘fast cast’ protocol for typical clubfeet

From: ‘Fast cast’ and ‘needle Tenotomy’ protocols with the Ponseti method to improve clubfoot management in Bangladesh

Author, date No. Participants = n Avg age at start Cast changed Avg days in casts - ‘fast’ group Tenotomy rate Follow up Comment
Morecuende, 2005 230 (non-random) Not stated 5 days 30 85% Study ran over 11 years Older study, NR sample
Harnett, 2011 40 (RCT) 21 days 3 / week 16 79% Min 6 mths Ave 8 mths Youngest children
Xu, 2011 26 (RCT) 92 days 2 / week 20.6 87% 2–6 years Manipulation time of 2 min
Ullah, 2014 28 (RCT) 18 weeks 2 / week 23.3 80% Not reported  
Elgohary, 2015 41 (RCT) 11 weeks (SD 7) 2 / week 18.1 (SD 3) 91% 12–48 mths Relapse rate 15% both groups
RCT data summary RCTs n = 135 11 weeks 2/week 19.5 days 84% average 1 year (3 RCTs) Young infants, 2 min. Stretch
  1. Corrective casts were changed twice/week in babies aged 0 to 12 weeks of age, using a longer manipulation/stretch time of two minutes.NB ‘fast casts’ applies only to treatment casts; post-tenotomy cast is required for 3 weeks