Clubfoot and congenital limb anomalies: Viva

This is a branching oral built to probe the reasoning that holds the four deformities, the Ponseti method, and the brace compliance at the centre, and to expose the candidate who has memorised the headline without the safety-critical corners. The questions escalate from the framing to the classification, the Ponseti method, the tenotomy and the brace, with deliberate probes into the syndromic clubfoot, the relapse, and the congenital limb anomalies. ^[5]

Opening question: framing the problem

The examiner opens with the rigid, inverted foot at the newborn baby check and asks: how do you frame this problem in a single sentence, and what is your first step? ^[1]

A strong answer names the idiopathic clubfoot from the rigid, inverted, adducted, and plantarflexed foot, and states that the first step is the exclusion of the syndromic associations and the prompt referral for the Ponseti method within the first week of life. ^[1][5]

Model answer. This child has the idiopathic clubfoot, from the rigid, inverted, adducted, and plantarflexed foot with the deep medial crease and the small heel in varus. The deformity is structural, not positional, because it does not correct with the passive manipulation. My first step is the full general examination to exclude the syndromic associations — the myelomeningocele, the arthrogryposis, and the other anomalies — and the prompt referral for the Ponseti method within the first one to two weeks of life. ^[1][10]

Probe one: the classification and the scoring