Staffing changes resulted in the expiration of IRB approval (2/15/12), and recruitment halted (n=84). IRB approval is now current for retrospective analysis.

The purpose of this study is to compare waterproof cast padding material to standard cotton/poly-cotton cast padding material to the presence or absence of cast sores of the heel.

Cast sores result in pain, scarring and sometimes disfigurement. No study has specifically evaluated the efficacy of waterproof cast padding with respect to preventing lower extremity cast sores.

Comparison: Non-blinded randomization to waterproof or cotton/cotton-poly cast padding material in a pediatric population who have lower extremity casts that include the foot and are applied in the operating room. Comparison of cast sore incidence will be made in the two randomized groups.

Inclusion Criteria:

• Patient at Shriners Hospital for Children - Honolulu
• Ages 0-18
• Short leg, long leg, spica or Petrie cast that includes the foot
• Cast applied in the operating room

Exclusion Criteria:

• Ponsetti casts (club foot casts with no more surgery than Achilles tenotomy, age < 1 year)
• Splints
• cylinder casts or spicas which don't include the foot