Management of Clubfoot by Joshis External Stabilizing System.A comparison between Spring distractors and Manual distractors.

Clubfoot is one of the oldest and commonest deformities affecting children. Severe clubfoot including neglected,recurrent and resistant forms cannot be managed by conservative methods and need surgical interventions. Surgery for Clubfoot has its own disadvantages. It is invasive and leads to scarring. Foot becomes rigid with soft tissue surgery and bony operations can make the foot even more smaller. To avoid it, a simple alternative is to use JESS and distractor components based on principle of controlled differential fractional distraction histogenesis. This is a percutaneous technique with minimal scarring allowing gradual distraction of soft tissues and align all the joints of foot so as to bring corrections of all aspects of deformity simultaneously. In this study, JESS fixator which is indigenous , less cumbersome , non bulky , economical and easy to apply. Latest addition in JESS assembly is spring distractor which utilise restoring force of the compressed spring to get desired distraction instead of daily manual distraction. Both manual and spring distractors for the correction of Clubfoot are acceptable methods. We are doing this study to find out which distraction sytem gives better and early correction and also is patient and user friendly.