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A mother brings in her 6-month-old infant with a knee deformity. The child had previously been treated with serial casting in flexion for 3 month at an outside facility. Examination reveals passive hyperextension to 25° and passive flexion to 15° as shown in Figures A and B respectively. A lateral radiograph of the knee is shown in Figure C. What is the most appropriate next step in treatment?
Serial above-knee casting in extension for 4 weeks.
Serial above-knee casting in flexion for 4 weeks.
Arthroscopic anterior cruciate ligament division, followed by above-knee casting
Percutaneous quadriceps recession, followed by above-knee casting
Open VY quadriceps plasty, followed by above-knee casting
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