Coupon Accepted Successfully!


Managment of CTEV

  1. At Birth and upto 1 year of age
    1. Manipulation &  weekly cast which maintains correction
    2. Even if the correction is achieved maintenance of foot in Dennis Browne splint or splints at night & CTEV shoe during day is recommended. Upto 7 year of age.
    3. Order of correction of deformities is
      1. Cavus
      2. Adduction
      3. Varus and Equinus
    4. If this order of correction is not followed and the equinus is corrected before adduction & inversion by forcefully dorsiflexing the foot, it may actually move at mid tarsal joints (not at ankle joint), producing rocker bottom deformity.


  1. Operatie Treatment
    1. The results of early operation, in particular neonatal surgery, have not been shown to be better than those of late surgery. Delaying surgery until the child is near walking age has the advantage of operating of larger foot (making surgery easier) as identification of structures is easy.
    2. Posteromedial soft tissue release is best done at young age (1-3 years). In children older than 3 years of age lateral column shortening procedures are often performed in conjunction with posteromedial soft tissue release.
    3. Triple arthrodesis is necessary for recurrent or persistent clubfoot deformity in older children (chronic cases). It is best done at 10-12 years of age when foot growth is complete.
    4. It involves fusion of three joints:
      TN - Talo-Navicular
      TC - Calcaneal
      CC - Calcaneo - Cuboid
    5. <1 year Cast 

B. 1 -3 years


Posteromedial soft tissue release

C. 4-10 years


Revision of soft tissue release together with shortening of lateral side of foot by

Lichtblau’s Procedure (i.e. Shortening of calcaneal neck proximal to calcaneocuboid joint)
Preferred in <6 years of age as calcancocuboid fusion is more difficult to achieve in this age.


Evan - Dillwyn Procedure (i.e. resection & fusion of calcaneo cuboid joint)
In 4-8 years of age (esp> 6years) is ideal procedure


* Dwyer’s osteotomy of calcaneum is done to correct calcaneal varus in >5 years

D. 8-10 years


Wedge tarsectomy

E. >10


Triple arthrodesis


* JESS & Ilizarov external fixators can also be applied.

Test Your Skills Now!
Take a Quiz now
Reviewer Name