Evaluation of Neglected Idiopathic Ctev Managed by Ligamentotaxis Using Jess: A Long-Term Followup

Abstract

Background. This study was conducted with the aim of evaluating the role of Ligamentotaxis in the management of neglected clubfeet managed by ligamentotaxis using Joshi's External Stabilisation System (JESS). Method & Material. Total 20 subjects (28 feet) were studied, which were corrected by differential ligamentotaxis using JESS. All were evaluated clinically, radiologically, podogrammically, and by Catterall Pirani Scoring System, both before and after the correction. Results. Severity of the deformities and clinical correction was assessed by Pirani score. All patients achieved good clinical results as per Pirani score, which was statistically significant. Radiological evaluation showed that all subjects achieved the normal range of values. The pre- and postcorrection difference in FBA was statistically significant. Conclusion. Differential distraction by fixator for the correction of neglected idiopathic CTEV is an effective and patient-friendly method of management.

Jess and Illizarov in Neglected /Relapsed Ctev: A Prospective Comparative Study

“…The goal of any club foot surgery is to obtain a cosmetically acceptable foot, pliable, functional, painless, plant grade foot and to spare the parent and the child from frequent hospitalization and years of treatment with casts and braces [1, 6,8].…”

Ponseti’s Method: Is It Effective in Conservative Management of Neglected Congenital Talipes Equino Varus

“…The employment of Posterior release or JESS [21] to achieve a plantigrade foot could be considered as treatment failure, in which case the Ponseti protocol failed in an additional 15% of cases, and the majority of such patients were older than 3 years of age. Our threshold to opt out of the protocol seemed to have increased during the course of the study as we got acquainted with the results of prolonging the period of treatment.…”

“…We used Steenbeek brace for FAB fig 1. JMSCR Vol||05||Issue||04||Page 21132-21140||April 2017 As it was cheaper, more customizable, and was available in larger sizes. When we felt that the treatment has reached a plateau phase and no further casting is showing any improvement, or if the equinus could not be corrected by tendo Achilles tenotomy alone, we opted out of the protocol labelled the patients as failures and used JESS [21] to treat the residual deformity.…”

“…Surgeries were conducted by attending consultant orthopaedic surgeons. When the treating surgeon felt that the treatment has reached a plateau phase and no further progress occurred, we mostly opted to treat using JESS distractor [21] , and such cases were considered failures. Once the patients were evaluated with Pirani's score (hindfoot contracture score (HFCS) out of 3, includes three components of empty heel, posterior crease and rigid equinus each having a score between 0 and 1; midfoot contracture score (MFCS) out of 3, including 3 components of lateral border, medial crease and reducibility of the head of the Talus).…”

Nonoperative Management of Neglected Clubfoot- Our Experience

“…In the system of Diméglio et al, four parameters are assessed on the basis of their reducibility with gentle manipulation as measured with a handheld goniometer (1) : equinus deviation in the sagittal plane, (2) varus deviation in the frontal plane, (3) derotation of the calcaneopedal block in the horizontal plane, (4) and adduction of the forefoot relative to the hind foot in the horizontal plane.…”