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Adapting Joshi External Stabilization System for Congenital Talipes Equinovarus Correction: A Practical Solution for Unavailable Distractor Sizes

Surgical Technique | Volume 12 | Issue 2 | May-August 2026 | Page: 44-46 | Md Zafar Iqbal, Anil Agarwal, Shivank Khurana DOI- https://doi.org/10.13107/ijpo.2026.v12.i02.282 Open Access License: CC BY-NC 4.0 Copyright Statement: Copyright © 2026; The Author(s). Submitted: 17/01/2026; Reviewed: 10/02/2026; Accepted: 25/05/2026; Published: 10/08/2026 Authors: Md Zafar Iqbal [1], Anil Agarwal [1], Shivank Khurana […]

Age Pattern and Bone Predilection in Pediatric Septic Arthritis and Osteomyelitis: A Retrospective Analysis at a Tertiary Care Center

Original Article | Volume 12 | Issue 2 | May-August 2026 | Page: 15-18 | Rupika T DOI- https://doi.org/10.13107/ijpo.2026.v12.i02.272 Open Access License: CC BY-NC 4.0 Copyright Statement: Copyright © 2026; The Author(s). Submitted: 03/05/2026; Reviewed: 22/05/2026; Accepted: 16/06/2026; Published: 10/08/2026 Authors: Rupika T [1] [1] Department of Paediatrics, Apollo Hospitals Chennai, Tamil Nadu, India. Address […]

Adapting Joshi External Stabilization System for Congenital Talipes Equinovarus Correction: A Practical Solution for Unavailable Distractor Sizes

Age Pattern and Bone Predilection in Pediatric Septic Arthritis and Osteomyelitis: A Retrospective Analysis at a Tertiary Care Center

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Adapting Joshi External Stabilization System for Congenital Talipes Equinovarus Correction: A Practical Solution for Unavailable Distractor Sizes

DOI- https://doi.org/10.13107/ijpo.2026.v12.i02.282

Open Access License: CC BY-NC 4.0

Submitted: 17/01/2026; Reviewed: 10/02/2026; Accepted: 25/05/2026; Published: 10/08/2026

Authors: Md Zafar Iqbal [1], Anil Agarwal [1], Shivank Khurana [1]

[1] Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, New Delhi, India.

Address of Correspondence

Md Zafar Iqbal,
Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, New Delhi – 110031, India.
E-mail: docmdzafariqbal@gmail.com

Abstract

Congenital talipes equinovarus is a complex foot deformity that is principally corrected by gradual manipulation. The Joshi external stabilization system (JESS) fixator uses this principle of gradual correction by ligamentotaxis. The principal component of the JESS system is the distractor applied at multiple planes to achieve soft-tissue stretching, enabling gradual correction of the deformity. As recommended, the size of the JESS should be at least 2/3rd of the limb to get maximum outcome. However, situations may arise where the exact size of the distractor is unavailable, posing a challenge to achieving optimal correction. This article describes a practical solution involving the use of an additional Z-rod or L-rod, allowing the application of a smaller size distractor. This adaptation ensures continued correction of the deformity, ultimately benefiting patients with optimal outcomes.
Keywords: Clubfoot, Joshi external stabilization system fixator, distractor, adaptation, surgical tip, children.

References

1. Ponseti IV, Smoley EN. The classic: Congenital club foot: The results of treatment. Clin Orthop Relat Res 2009;467:1133-45.
2. Joshi BB, Prabhoo R, Kanaji BG, Kaushik. Management of Clubfoot by Joshi’s External Stabilization System (JESS). Uttar Pradesh: Jaypee; 2010.
3. Singh A. Evaluation of neglected idiopathic ctev managed by ligamentotaxis using jess: A long-term followup. Adv Orthop 2011;2011:218489.
4. Altaf KA, Shah SB, Ahmad S, Mumtaz U, Mantoo SA. Results of JESS (Joshi’s external stabilizing system) in relapsed, neglected and neurogenic clubfoot in an age group of 2-10 years. Ortop Traumatol Rehabil 2020;22:121-9.
5. Suresh S, Ahmed A, Sharma VK. Role of Joshi’s External Stabilisation System Fixator in the Management of Idiopathic Clubfoot. J Orthop Surg 2003;11:194-201.

How to Cite this Article: Iqbal MZ, Agarwal A, Khurana S | Adapting Joshi External Stabilization System for Congenital Talipes Equinovarus Correction: A Practical Solution for Unavailable Distractor Sizes | International Journal of Paediatric Orthopaedics | May-August 2026; 12(2): 44-46.

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Age Pattern and Bone Predilection in Pediatric Septic Arthritis and Osteomyelitis: A Retrospective Analysis at a Tertiary Care Center

DOI- https://doi.org/10.13107/ijpo.2026.v12.i02.272

Open Access License: CC BY-NC 4.0

Submitted: 03/05/2026; Reviewed: 22/05/2026; Accepted: 16/06/2026; Published: 10/08/2026

Authors: Rupika T [1]

[1] Department of Paediatrics, Apollo Hospitals Chennai, Tamil Nadu, India.

Address of Correspondence

Dr. Rupika T
Department of Paediatrics, Apollo Hospitals Chennai, Tamil Nadu, India.
E-mail: rupithiru@gmail.com

Abstract

Background: Pediatric musculoskeletal infections, specifically septic arthritis (SA) and osteomyelitis (OM), are significant causes of morbidity. Understanding local epidemiological trends is vital for early diagnosis and empirical management.
Objectives: To analyze age-specific patterns and the anatomical predilection of bones and joints affected by SA and OM in a tertiary hospital setting.
Methods: This retrospective study reviewed pediatric patients (0–18 years) diagnosed with SA or OM over 8 years. Data on age, gender, infection site, and microbiology were analyzed.
Results: A retrospective analysis of 210 pediatric cases revealed a male preponderance (58%). The mean age was 10.8 years. The tibia (21%) and femur (20%) were the most common bones involved in OM. A significant portion of the cohort (29%) presented with SA, with the hip (18%) and knee (14%) being the most frequently affected joints. Chronic presentations and post-infectious sequelae, such as joint dislocations and pathological fractures, were prevalent, particularly in cases involving the proximal femur and hip joint.
Conclusion: Long bones of the lower limb and the major weight-bearing joints (hip and knee) are the primary sites of pediatric musculoskeletal infections at our center. The significant incidence of joint-related sequelae highlights the critical importance of early surgical debridement and long-term follow-up in managing these infections to preserve joint function and limb alignment.
Keywords: Pediatric orthopedics, septic arthritis, osteomyelitis, bone predilection, epidemiology.

References

1. Trueta J. The three-dimensional vascularity of the metaphysis. J Bone Joint Surg Br 1959;41-B:392-400.
2. Peltola H, Pääkkönen M. Acute osteomyelitis in children. N Engl J Med 2014;370:352-60.
3. Gafur OA, Copley LA, Hollmig ST, Browne RH, Thornton LA, Crawford SE. The impact of the current epidemiology of pediatric musculoskeletal infection on evaluation and treatment guidelines. J Pediatr Orthop 2008;28:777-85.
4. Dartnell J, Ramachandran M, Katchburian L. Haematogenous acute and subacute paediatric osteomyelitis: A systematic review of the literature. J Bone Joint Surg Br 2012;94:584-95.
5. Ilharreborde B. Sequelae of pediatric osteoarticular infection. Orthop Traumatol Surg Res 2015;101 Suppl 1:S129-37.
6. Dodwell ER. Osteomyelitis and septic arthritis in children: Current concepts. Curr Opin Pediatr 2013;25:58-63.
7. Montgomery CO, Siegel E, Blasier RD, Suva LJ. Concurrent septic arthritis and osteomyelitis in children. J Pediatr Orthop 2013;33:464-7.
8. Safdieh G, Silberman J, Nguyen J, Doyle SM, Blanco JS, Scher DM, et al. Pediatric septic arthritis and osteomyelitis in the USA: A national KID database analysis. HSS J 2019;15:159-66.

How to Cite this Article: Rupika T | Age Pattern and Bone Predilection in Paediatric Septic Arthritis and Osteomyelitis: A Retrospective Analysis at a Tertiary Care Center | International Journal of Paediatric Orthopaedics | May-August 2026; 12(2): 15-18.

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