In the Ponseti method for clubfoot (CTEV) correction, casting is performed weekly. The sequence of correction follows the mnemonic CAVE. What does each letter represent and in which order are the deformities corrected?

• A Calcaneus, Abduction, Varus, Equinus
• B Clubbing, Ankle equinus, Valgus, External rotation
• C Cavus, Ankle varus, Valgus, Extension
• D Cavus, Adductus, Varus, Equinus — corrected in that order ✓

Explanation

The Ponseti method corrects CTEV deformities in the sequence CAVE: Cavus (arch elevation — corrected first by supinating the forefoot to align with hindfoot), Adductus (forefoot adduction), Varus (hindfoot varus), Equinus (last, corrected by abducting the foot in cast with counter-pressure at lateral talus head, followed by percutaneous Achilles tenotomy in ~80% of cases). Equinus is corrected last because correcting it first drives the calcaneus into varus. The cast series typically requires 5–7 casts over 5–7 weeks; a foot abduction brace (FAB) is worn for 4 years to prevent relapse.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.