Clubfoot (CTEV) is a deformity in which an infant’s foot (unilateral or bilateral) is turned downward (equinus) and inward (varus), often so severely that the bottom of the foot faces sideways or even upward. Approximately one infant in every 1,000 live births suffer from clubfoot, making it one of the most common congenital (by birth) deformities. The exact cause is usually not identified but both genetic and environmental factors are believed to be involved. 

Courtesy: https://babygizmo.com/wp-content/uploads/2015/01/h9991603_001.jpg

Unilateral: When only one foot is affected.

Courtesy: https://www.paediatricsandchildhealthjournal.co.uk/article/S1751-7222(16)00030-5/abstract

Bilateral: When both feet are affected

Courtesy: https://www.researchgate.net/profile/Yuxi_Su

Ponseti method of clubfoot treatment (Non-invasive):

The Ponseti method is the gold standard of clubfoot treatment with correction rate 90% or higher. The Ponseti techniques is adopted in 113 United Nations member countries out of 193. 

The Ponseti method consists of a specific technique of manipulation of the clubfoot deformity, followed by the application of a plaster cast in series with the foot in the corrected position. A percutaneous tenotomy of the Achilles tendon is done prior to the final cast to gain complete correction in most patients.  Bilateral bracing with a foot abduction orthosis is necessary to minimize relapse of the deformity as long as 23 hours per day initially to minimum 6 hours per day for years.

Outline of Ponseti treatment

Series of casts in Ponseti Treatment

Bracing with a foot abduction orthosis for maintenance

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