Congenital Talipes Equino Varus (CTEV) is known as clubfoot. It is a deformity in which an infant’s foot is turned inward, often so severely that the bottom of the foot faces sideways or even upward.

Clinical presentation sign and symptoms

  • foot is turned inward and there is often a deep crease on the bottom of the foot.
  • Walk on the outer edge of their foot instead of the sole
  • Develop painful calluses
  • Be unable to wear shoes
  • Have lifelong painful feet that often severely limit activity
  • The affected leg or foot may be slightly shorter.
  • The calf muscles in the affected leg are usually underdeveloped.


Non operative

  • Ponseti method of serial manipulation and casting
  • French method of daily physical therapy, manipulation and splinting


  • posteromedial soft tissue release and tendon lengthening
  • talectomy
  • ring fixator (Taylor Spatial Frame) application and gradual correction triple arthrodesis

CTEV will progressive increase in deformity if not managed initially. If not managed, the child will learn to stand and walk with a deformed foot.
With an increase in age and weight, foot deformity can progress to pain, abnormal walking pattern, and shoe wear and tear

The main goal of ctev treatment is to correct the way your child’s foot looks and works before your child learns to walk.

Postural CTEV is self revolving, but sometimes massage, stretching & manipulation may be required.

Other stiff & rigid variety need manipulation and plaster application.

Universal ctev treatment process is the Ponsetty methods of manipulation and repeated plaster application for 5-6 times at 7-10 days interval followed by Percutaneous tenotomy & plaster for 1 month.

The child has to wear special shoes (Dennis brown splint) day and night till the age of 18 months or for a longer. Stretching exercise, planter stimulation, and oil massage are advised to continue till the child start walking.

Prepared By

Nur Aisyah Binti Ahmad Kamal & Nor Ashima Binti Mamat

Your Physio Ampang

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