Congenital talipes equinovarus, commonly known as clubfoot, is a rigid deformity present at birth that requires structured, sequential management. In this Orthovellum masterclass, we explore the Ponseti method, the CAVE deformity sequenceand the critical role of foot abduction bracing in preventing relapse. ⏱ Chapters 0:00 Intro 0:28 Essentials 1:00 Cave 1:21 Pirani 1:43 Classification 2:07 Algorithm 2:33 Numbers 2:54 Relapse 3:16 Clinical reasoning — Newborn 3:39 Clinical reasoning — Relapse This video provides a comprehensive breakdown of clubfoot pathoanatomy, classificationand evidence-based treatment. We demonstrate why the Ponseti protocol of serial casting, percutaneous Achilles tenotomyand bracing achieves over ninety percent correction ratesand detail how to objectively monitor deformity resolution using the Pirani scoring system. 🦴 IN THIS VIDEO YOU'LL LEARN • How to identify the four components of the CAVE deformity: cavus, adductus, varusand equinus • The pathoanatomy of clubfoot including the smaller, medially deviated talus and contracted soft tissues • How to calculate and interpret the Pirani score using the PELHMM mnemonic • The step-by-step Ponseti casting sequence and why correcting in the wrong order causes rocker-bottom deformity • The indications and timing for performing a percutaneous Achilles tenotomy • The foot abduction bracing protocol required to maintain long-term correction • How to classify clubfeet as idiopathic, neuromuscularor syndromic and understand their differing prognoses • The essential role of family education and bracing compliance in preventing the thirty to fifty percent relapse rate • The clinical approach to managing recurrent deformity and when to consider posteromedial release ⏱️ CHAPTERS 📌 KEY TAKEAWAYS ✔️ Correct the CAVE components strictly in sequence: cavus, adductus, varusand finally equinus. ✔️ A Pirani score greater than four predicts the need for a percutaneous Achilles tenotomy in over eighty percent of cases. ✔️ Never force dorsiflexion before correcting adductus and varus to avoid creating a midfoot break. ✔️ Foot abduction brace compliance is the single most important factor in preventing relapse. ✔️ Always screen for associated neuromuscular conditions like spina bifida and arthrogryposis. ✔️ Manage relapse first by repeating the Ponseti casting protocol before considering extensive surgery. 👩⚕️ WHO THIS IS FOR This masterclass is designed for orthopaedic trainees, medical studentsand clinicians seeking a comprehensive understanding of paediatric foot deformities, as well as curious patients and families looking to understand the gold-standard management of clubfoot. 📚 RELATED TOPICS: Developmental Dysplasia of the Hip (DDH) · Arthrogryposis Multiplex Congenita · Congenital Vertical Talus · Percutaneous Achilles Tenotomy Technique · Posteromedial Release for Resistant Clubfoot · Neuromuscular Foot Deformities in Cerebral Palsy 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #orthopaedics #clubfoot #paediatricorthopaedics #ponseti #congenitaltalipes #orthopaedicsurgery #medicalstudent #doctor #piraniscore #orthoteaching #paediatrics #footandankle