miscellaneous/talipes equinovarus (club foot)

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Orthopedics

miscellaneous

talipes equinovarus (club foot)

A 6-month-old infant girl is brought to her pediatrician for a routine wellness visit. Her parents express ongoing concern regarding her left foot, which was diagnosed at birth with an inward turning deformity. She has been undergoing various stretching exercises and serial casting applications since shortly after birth. Despite these concerted efforts, her parents report only minimal improvement in the foot's position. On physical examination, the left foot presents with notable adduction and inversion of the forefoot and midfoot, and passive dorsiflexion is severely limited, not exceeding 90 degrees. The midtarsal joint complex feels notably rigid upon gentle manipulation, and the heel appears small and internally rotated. Initial laboratory investigations reveal a normal complete blood count. What is the most likely diagnosis and the subsequent most appropriate management strategy for this infant?

Lab ParameterValueReference Range
Hemoglobin125 g/L110-140 g/L
White Blood Cell Count9.5 x 10^9/L6.0-17.0 x 10^9/L
Platelet Count350 x 10^9/L150-450 x 10^9/L

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