{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T22:43:56Z","timestamp":1790635436125,"version":"4.1.0"},"reference-count":26,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>The Ponseti method is the gold standard for managing congenital talipes equinovarus (CTEV); however, relapses leading to surgical intervention remain a significant challenge. We investigated the factors associated with a higher risk of relapse. A retrospective study of 31 children (\u22644 years) with CTEV treated with the Ponseti method between January 2014 and December 2023 was conducted. Demographic and clinical data\u2014age at treatment, aetiology, Pirani score, number of casts, percutaneous Achilles tenotomy (PAT), surgery, bracing, relapses, and follow-up\u2014were collected. Descriptive statistics, univariate analyses, and logistic regression were conducted to identify risk factors for relapse. Of the 31 patients, 67.7% were male, 58.1% had bilateral involvement and 71.0% had idiopathic CTEV. The median age at presentation was 2 months (IQR 1\u20133), and the initial Pirani score 5.0, improving to 0.0 at final follow-up (p &lt; 0.001). The median number of casts was 7 (IQR 5\u201310), which correlated with the initial Pirani score (p = 0.021). PAT was performed in 77.4%; surgical intervention was required in 32.3%, most commonly repeat tenotomy (41.2%). The median bracing duration was 84 weeks (IQR 32\u2013136) with 64.5% compliance. Relapses occurred in 35.5% of cases; 72.7% required recasting and surgery. Logistic regression identified brace compliance (p &lt; 0.001) as the only significant factor; compliant patients had 90% lower odds of relapse. Non-compliance with bracing significantly increases the risk of relapses and surgical intervention in children with CTEV treated by the Ponseti method. Close monitoring and strict adherence to bracing are essential for an optimal outcome.<\/jats:p>","DOI":"10.3390\/life16030483","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T11:13:14Z","timestamp":1773659594000},"page":"483","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk Factors for Relapse and Surgical Intervention in Children with CTEV Treated by Ponseti Method"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3937-0597","authenticated-orcid":false,"given":"Kamal","family":"Jamil","sequence":"first","affiliation":[{"name":"Department of Orthopaedics & Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yee Suan","family":"Goh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics & Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siti Aqilah Aina","family":"Azman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics & Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dharrsini","family":"Sathis","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics & Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baskaran","family":"Ramachandran","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics & Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon Nuil","family":"Grippin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics & Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad Fazly","family":"Abd Rasid","sequence":"additional","affiliation":[{"name":"Orthopaedic Unit, Hospital TABTAR (Children\u2019s Specialist Hospital), Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.1007\/s00590-022-03353-5","article-title":"A 5-years results of the Ponseti method in the treatment of congenital clubfoot: A retrospective study","volume":"33","author":"Bitew","year":"2023","journal-title":"Eur. 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