Vol. 12, Issue 2 (2026)

Background: Congenital Talipes Equinovarus (CTEV), or clubfoot, is a prevalent birth defect occurring in 1 in 1,000 live births. If untreated, it causes lifelong disability. This study evaluates the management and genetic research of clubfoot at the Government Coimbatore Medical College and Hospital (CMCH), India.

Materials and Methods: A longitudinal study was conducted between 2011 and 2025 involving 581 children (345 male, 236 female) aged up to 10 years. Treatment followed the gold-standard Ponseti technique, utilizing serial casting and, where necessary, percutaneous tenotomy of the tendoachilles. Additionally, genetic analysis was performed on blood samples from 50 children to identify Single Nucleotide Polymorphisms (SNPs) in the PITX1 gene.

Results: Out of 581 children, only 105 (18%) required surgical tenotomy to achieve a plantigrade foot, a significantly lower rate than other Indian studies (ranging from 84% to 100%). Genetic results identified 27 different SNPs. Specifically, the Chr5:135031277 C>T mutation was significantly associated with isolated clubfoot, being 2.26 times more likely to occur than previously reported pathogenic mutations in this population (P=0.0463).

Discussion and Conclusion: The success of the CMCH model is attributed to early intervention, meticulous serial casting without limiting the number of applications, and dedicated parent counseling. The study demonstrates that the Ponseti technique remains highly effective in high-volume public health settings. Furthermore, the genetic findings suggest regional variations in the genetic "drivers" of clubfoot in the Indian demographic