The key principles of the Ponseti technique for treatment of CTEV :-
1. All deformity components are corrected simultaneously except equinus, which is corrected last, usually by percutaneous Achilles tenotomy.
>Simultaneous correction achieved at talonavicular, calcaneocuboid & talocalcaneal joints.
2. The correction is maintained by external foot rotation around the head of the talus. Simultaneous abduction is done at Lisfranc, calcaneonavicular, Chopart & subtalar joint with pressure at talus head laterally & not touching the calcaneous(heel).
3. The cavus is corrected by supination of the first ray of the foot.
4. The corrections are performed weekly & A/K POP cast applied & after 4-5 weeks of treatment, a percutaneous Achilles tenotomy is done in local or general anaesthesia.
5. After another 3 weeks of plaster cast immobilisation, a Foot-abduction brace e.g.