{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T09:00:02Z","timestamp":1768381202361,"version":"3.49.0"},"reference-count":0,"publisher":"Indian Orthopaedic Research Group","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Jocr"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>Introduction: Congenital talipes equinovarus (CTEV) is a common pediatric deformity, with conservative management being the primary method of management. Despite the high corrective rates of this modality, relapses, residual, and resistant cases do occur. The cause of these conditions is multifactorial, and there exists a difference of opinion regarding the management of such cases. The study aimed to provide clinically relevant outcome data in this specific and less frequently encountered population. The relatively small sample reflects the rarity of idiopathic relapsed, residual, and resistant CTEV and provides valuable preliminary data to guide future larger studies.\n\nMaterials and Methods: This prospective, descriptive, observational study included 33 clubfeet in 25 patients presenting with relapsed, residual, or resistant CTEV between July 2022 and June 2024. Patients were treated with either Ponseti\u2019s method, including serial manipulation, casting, and tendo-achilles tenotomy, or Joshi\u2019s external stabilization system (JESS), a minimally invasive external fixation technique. Pre- and post-correction outcomes were assessed using the Pirani and Dimeglio scoring systems. Data on treatment compliance, complications, and outcomes were analyzed.\n\nResults: The mean age of patients was 44.6 months, ranging from 9 months to 8 years. Among 33 feet, 19 were classified as relapsed (59%), 9 as residual (28%), and 5 as resistant CTEV (13%). Ponseti\u2019s method was used for 45.45% of feet, and JESS for 54.55%. Post-correction Pirani scores improved significantly (mean pre-correction 4.11, post-correction 0.55; P &lt; 0.001). Similarly, Dimeglio\u2019s scores improved (mean pre-correction 13.22, post-correction 2.88; P &lt; 0.001). Complications were minimal and manageable, including cast slippage and pin-tract infections. JESS demonstrated superior outcomes for older children with more severe deformities.\n\nConclusion: Both Ponseti\u2019s method and JESS are effective for managing relapsed, residual, and resistant CTEV, with JESS particularly beneficial for older children. Recurrence is commonly associated with inadequate bracing and follow-up. Comprehensive management, including early treatment, patient education, and consistent follow-up, is crucial for achieving and maintaining correction.\n\nKeywords: Congenital talipes equinovarus, Ponseti technique, Joshi\u2019s external stabilization system, relapse congenital talipes equinovarus, recurrent congenital talipes equinovarus, residual congenital talipes equinovarus.<\/jats:p>","DOI":"10.13107\/jocr.2026.v16.i01.6716","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T03:23:46Z","timestamp":1768361026000},"page":"413-420","source":"Crossref","is-referenced-by-count":0,"title":["Management of Relapsed, Residual, and Resistant Idiopathic Congenital Talipes Equinovarus"],"prefix":"10.13107","volume":"16","author":[{"name":"Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohd Owais","family":"Ansari","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasir Salaam","family":"Siddiqui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faisal","family":"Harun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyson","family":"Rana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaustubh","family":"Hari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mazhar","family":"Abbas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5271","published-online":{"date-parts":[[2026]]},"container-title":["Journal of Orthopaedic Case Reports"],"original-title":[],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T03:24:31Z","timestamp":1768361071000},"score":1,"resource":{"primary":{"URL":"https:\/\/jocr.co.in\/wp\/2026\/01\/management-of-relapsed-residual-and-resistant-idiopathic-congenital-talipes-equinovarus\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]},"published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.13107\/jocr.2026.v16.i01.6716","relation":{},"ISSN":["2321-3817"],"issn-type":[{"value":"2321-3817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}