Technique of Ponseti casting for clubfoot correction (see text). A, First cast; note positioning of forefoot to align with heel, with outer edge of foot tilted even farther downward because of Achilles tendon tightness. B, Second cast is applied with outer edge of foot still tilted downward and forefoot moved slightly outward. C, Third cast; Achilles tendon is stretched bringing outer edge of foot into more normal position as forefoot is turned farther outward. D, Final cast; Achilles tendon is stretched more with foot pointed upward.