A clinical study of neglected idiopathic CTEV managed by ligamentotaxis using Joshi’s external stabilising system

Abstract

Congenital Talipes Equino Varus is the commonest deformity of the foot and affects males 10:7 more often than females. The incidence worldwide is 1-2 per 1000 live births. Although most cases are sporadic occurrences, families have been reported with clubfoot as an autosomal dominant trait with incomplete penetrance.Aims and objectives: This study was conducted with the aim of evaluating the efficacy of the controlled differential fractional distraction with Joshi’s External Stabilisation System (JESS) as a method of treatment in resistant clubfeet and the morbidity and complications of the technique and to suggest ways to overcome them.Methodology: The prospective study was done in a tertiary care center involving subjects with old, recurrent and resistant cases of clubfoot deformities treated by Joshi’s external stabilizing system.Results: All the cases were evaluated clinically, radiologically both before and after correction. The cosmetic and functional improvement is satisfactory, bony radiological correction comparable, and the ankle movements especially dorsiflexion better than that produced by open surgery.Conclusion: Correction by an external fixator is a useful method for the management of clubfoot in neglected and resistant cases.