Vol 34 | Issue 1 | Jan – April 2019 | page: 21-25 | Ashwani Sadana, Karuna Shankar Dinkar, Chandra Prakash Pal, Rajat Kapoor, Yajuvendra Kumar
Authors: Ashwani Sadana , Karuna Shankar Dinkar , Chandra Prakash Pal , Rajat Kapoor , Yajuvendra Kumar 
Address of Correspondence
Dr. Karuna Shankar Dinkar,
Department of Orthopaedics,
Sarojini Naidu Medical College,
Agra – 282 002, Uttar Pradesh, India.
Club foot is among the most common of congenital deformities. Congenital talipes equinovarus is a complex three-dimensional deformity having four components – equinus, varus, adduction, and cavus. The present study was conducted to compare the results of posteromedial soft-tissue release (PMSTR) and Joshi’s external stabilizing system ( JESS) fixator in neglected, resistant, and relapsed
or recurrent club foot. This a prospective study comprising of 36 children was conducted in the department of orthopedics, S.N. Medical College, Agra. Pre-operative none of the feet in either group had a clinical satisfactory rating, but after surgery, a significant improvement was seen. Of the 25 feet subjected to PMSTR procedure, it was observed that 16 feet (64%) were in the category of the satisfactory rating where all the 9 clinical criteria were in satisfactory range (36%) had an unsatisfactory result. Of the 22 feet subjected to differential distraction method using JESS fixator, it was observed that 19 feet (77.3%) were in the category of satisfactory rating, where all the 9 criteria were in satisfactory range, and the unsatisfactory result was seen in 5 feet (22.7%).
Keywords: Cavus, compare, Pre-operative, Joshi’s external stabilizing system, Feet
1.Kelly EC. Hippocrates (400B.C.): The Genuine Work of Hippocrates Translated from Greek by Francis Adams with an Introduction. Philadelphia, PA: Williams and Wilkins; 1939.
2.Ikeda K. Conservative treatment of idiopathic clubfoot. J Pediatr Orthop 1992;12:217-23.
3.Ilizarov GA. Clinical application of the tension-stress effect for limb lengthening. Clin Orthop 1990;250:8-26.
4.Joshi BB, Laud NS, Warrier SS, Kanaji BG, Joshi AP, Dabake H. Treatment of CTEV by Joshi External Stabilization System (JESS) In Kulkarni GS, editor. Textbook of Orthopedics and Trauma. Ist ed. New Delhi: Jaypee Brothers Medical Publishers Ltd.; 1999.
5.Turco VJ. Resistant congenital club foot one-stage posteromedial release with internal fixation. A follow-up report of a fifteen-year experience. J Bone Joint Surg Am 1979;61:805-14.
6.McKay DW. New concept of and approach to clubfoot treatment: Section II correction of the clubfoot. J Pediatr Orthop 1983;3:10-21.
7.Yamamoto H, Furuya K. One-stage posteromedial release of congenital clubfoot. J Pediatr Orthop 1988;8:590-5. Simons GW. Complete subtalar release in clubfeet. J Bone Joint Surg 1985;67:105665.
8.Grill F, Franke J. The ilizarov distractor for the correction of relapsed or neglected clubfoot. J Bone Joint Surg Br 1987;69:593-7.
9.Suresh S, Ahmed A, Sharma VK. Role of Joshi’s external stabilization system fixator in the management of idiopathic clubfoot. J Orthop Surg (Hong Kong) 2003;11:194-201.
10. Sudmann E, Hald JK Jr., Skandfer B. Features resisting primary treatment of congenital club foot. Acta Orthop Scand 1983;54:850-7.
11.Cohen-Sobel E, Caselli M, Giorgini R, Giorgini T, Stummer S. Long-term follow-up of clubfoot surgery: Analysis of 44 patients. J Foot Ankle Surg 1993;32:411-23.
12.Ponseti IV. Treatment of congenital club foot. J Bone Joint Surg Am 1992;74:448-54.
|How to Cite this Article: Sadana A, Dinkar K S, Pal C P, Kapoor R, Kumar Y. A Comparative Analysis of Posteromedial So-Tissue Release and Differential Distraction with Joshi’s External Stabilizing System Fixator in Neglected Resistant Congenital Talipes Equinovarus. Journal of Bone and Joint Diseases Jan – Apr 2019;34(1):20-24.