LETTER TO THE EDITOR Tincture of Benzoin to Prevent Cast Slippage in Clubfoot

Children with clubfoot are often referred to our paediatric orthopaedic clinic from other hospitals. Parents sometimes complained that the plaster casts frequently slips off the foot. This is known to occur especially in babies with chubby or stubby feet. In our institution, tincture of benzoin (Fig. 1) is used to prevent the clubfoot cast from slipping off. Tincture of benzoin consists of benzoin and alcohol. Benzoin is derived from the resin of a tree, Styrax benzoin 1 which is native to Sumatra and is known locally as the kemenyan tree. Tincture of benzoin is painted on the skin before applying the cotton roll (Fig. 2a). It acts as an adhesive allowing the cotton roll to stick to the skin (Fig. 2b) and prevents the cast from slipping. Manipulation of the foot and casting (Fig. 2c) is done according to the Ponseti technique 3 . Using tincture of benzoin for clubfoot has been well documented in the literature 4,5 . The aim of this letter is to recommend and highlight the use of tincture benzoin to prevent clubfoot cast slippage as its use may not be widespread in Malaysia.