In a child under 2 with recurrence after Ponseti treatment, which approach is recommended?

In a child under 2 with recurrence after Ponseti treatment, which approach is recommended?

• A. Repeat the same treatment
• B. Osteotomy
• C. Tenotomy
• D. Do nothing

Answer: (A)

Relapsed clubfoot in a child under 2 is most effectively managed by reapplying the Ponseti casting protocol. The young foot still has strong remodeling potential, and the Ponseti method is designed to be repeated if a relapse occurs. Recasting reestablishes full correction within the same framework, and if the deformity recurs at the equinus, a second percutaneous Achilles tenotomy can be added within that approach. More invasive options like osteotomy are typically reserved for older children or for rigid relapses that cannot be corrected with casting, and doing nothing would allow the deformity to worsen.

Relapsed clubfoot in a child under 2 is most effectively managed by reapplying the Ponseti casting protocol. The young foot still has strong remodeling potential, and the Ponseti method is designed to be repeated if a relapse occurs. Recasting reestablishes full correction within the same framework, and if the deformity recurs at the equinus, a second percutaneous Achilles tenotomy can be added within that approach. More invasive options like osteotomy are typically reserved for older children or for rigid relapses that cannot be corrected with casting, and doing nothing would allow the deformity to worsen.