Management of Congenital Talipes Equinovarus by Joshi’s External Stabilizing System

Introduction: Joshi’s external stabilizing system (JESS) is a useful option to correct the deformities in patients who present to the orthopedic department with neglected congenital talipes equinovarus, Plaster of Paris (POP) drop out cases, or failed surgical procedures. Purpose: We aimed to analyze a short term follow-up study of 16 patients with 4 bilateral cases treated with JESS at the Department of Orthopedics, JJM Medical College, Davangere, in terms of cosmetic, functional, and anatomical outcome. Methods: A total of 16 children underwent 20 JESS procedures at the Department of Orthopaedics, JJM Medical College, affiliated to Chigateri Government Hospital, Davangere and Bapuji Hospital, Davangere, during the period from September 2008 to September 2010. Patients were followed up regularly. Three-dimensional corrections were achieved by the use of the distractor device. Results: Excellent results were obtained in 15 feet, good results in two feet, fair in one foot, and poor in one foot. The most common complication we encountered was pin tract infection which eventually healed on an outpatient basis without any residual sequelae. Conclusion: The Joshi’s external stabilization system frame is ideally suited for children in whom clubfoot deformities remain uncorrected by POP cast manipulations as well as recurrent/relapsed clubfoot. The procedure is minimally invasive, and the results are good irrespective of the severity of the deformity.