A newborn's left foot is noted to be in equinus, varus, cavus, and forefoot adductus. The foot cannot be passively corrected to a neutral position. The most appropriate initial treatment is:

• A Ponseti method of serial manipulations and casting from birth ✓
• B Surgical correction at 6 months of age
• C Physiotherapy stretching exercises alone
• D Denis Browne splint application without casting

Explanation

Congenital talipes equinovarus (CTEV) requires early treatment taking advantage of the plasticity of neonatal soft tissues. The Ponseti method — weekly serial plaster of Paris casts correcting cavus, varus, and adduction first before equinus — is the gold standard, achieving correction in over 90% of cases. The equinus is corrected last, usually requiring a percutaneous Achilles tenotomy. A foot abduction brace is worn thereafter to prevent relapse.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.