ABSTRACT
introduction: Clubfoot and its management have been the topic of keen interest to the orthopedics field ever since timeimmemorial and many techniques in the successful management of these have been advocated till date. This study discussesone such technique of management in children with Joshi’s external stabilization system (JESS) fixator.Aim: This study aims to evaluate the role of JESS in the management of neglected, resistant and relapsed congenital talipesequinovarus (CTEV), in the age group of 1–6 years.Materials and Methods: A total of 20 feet in 20 children underwent JESS fixation surgery at the Department of Orthopaedics,Government Rajaji Hospital, Madurai Medical College, from October 2015 to September 2018.Results: Four patients had excellent results, 12 patients had good results with an average score of 78, three patients had fairresults, and poor results in one patient. The average pre-operative Pirani score was 4.5 and post-operative score of 0.93 withP < 0.001 which was statistically significant. The average pre-operative Dimeglio score was 12 (Stage III) which statisticallyimproved post-operative (P < 0.001) to 5 (Stage 1).Conclusion: By controlled differential distraction using JESS apparatus, a painless, Pliable, plantigrade. The perfect sized andcosmetically acceptable foot has been obtained even in children 1 year–6 years. Controlled differential distraction using JESSfixator has got a definite role in the management of relapsed and neglected CTEV and it does not prevent the foot from beingtreated surgically at a later date if needed.