Generally speaking, conservative management with serial casting (ponsetti) is the first line treatment.
Most treatment plans with serial casting are effective and avoid the need for extensive surgical correction. Some patients require small surgeries such as an achilles lengthening with the casting treatment. If this fails, surgical correction can be performed. Most surgeons would like to have a plantigrade (corrected) foot by the time the child begins to walk-(around 12 months of age). For those that do not respond to serial casting( ponsetti) surgical correction should be performed between 6-9 months of age.