Orthonotes
Orthonotes
by the.bonestories
v3.0 Fusion
v3.0 Fusion
pediatrics topic hub

Congenital Talipes Equinovarus — Relapse & Tibialis Transfer

Relapse often due to **brace non‑compliance**; dynamic supination is common in toddlers. Initial management is **re‑casting** following Ponseti principles; evaluate for residual equinus/adductus. **Tibialis Anterior Tendon Transfer (TATT)** indicated for persistent dynamic supination after walking age. Technique: split or whole TATT to lateral cuneiform (through bone tunnel or anchors) with foot held in dorsiflexion/eversion. Severe rigid relapses may require posteromedial release or external fixation; address cavus and forefoot adductus carefully.

Overview

Topic summary

View wiki
Relapse often due to **brace non‑compliance**; dynamic supination is common in toddlers. Initial management is **re‑casting** following Ponseti principles; evaluate for residual equinus/adductus. **Tibialis Anterior Tendon Transfer (TATT)** indicated for persistent dynamic supination after walking age. Technique: split or whole TATT to lateral cuneiform (through bone tunnel or anchors) with foot held in dorsiflexion/eversion. Severe rigid relapses may require posteromedial release or external fixation; address cavus and forefoot adductus carefully.
Resources

Reading and supporting material

MCQs

High-yield practice questions

Start topic quiz
Question 1

What is the most common cause of relapse in congenital talipes equinovarus after initial treatment with the Ponseti method?

Question 2

During the Ponseti method, which component of the CTEV deformity is corrected last?

Question 3

What is the primary indication for performing a tibialis anterior tendon transfer (TATT) in patients with CTEV?

Question 4

What is the incidence of relapse in children treated with the Ponseti method for CTEV?

Question 5

What is the role of the foot abduction brace (FAB) in the management of congenital talipes equinovarus?

Question 6

Which technique is used for tibialis anterior tendon transfer?

Question 7

What is the expected correction sequence during Ponseti casting for CTEV?

Question 8

What is a common manifestation of relapse in CTEV after successful treatment?

Question 9

What additional surgical intervention may be required for severe rigid relapses of CTEV?

Question 10

What is the primary purpose of a post-tenotomy cast in the Ponseti method?