Secondary prevention

Recurrence is prevented by continuing the brace-wear schedule. The foot demonstrates return of metatarsus adductus with loss of dorsiflexion if the brace is not used. With recurrence of deformities, repeat casting and/or surgery may be indicated.[21]

Risk factors for surgical intervention include noncompliance with the orthosis, female sex, more severe clubfoot both at presentation and at initiation of the orthosis, and any additional casting prior to the orthosis.[55][56]

Occasionally there can be a recurrence after a tibialis tendon transfer for dynamic supination in patients being treated by the Ponseti method. Poor brace compliance and a young age at the time of a tibialis anterior tendon transfer are predictive of a second clubfoot recurrence.[57]

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