Journal of Foot and Ankle Surgery (Asia Pacific)

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VOLUME 11 , ISSUE 1 ( January-March, 2024 ) > List of Articles


Inadvertent Metatarsal Lengthening and Hallux Valgus Associated with JESS in a Case of AMC: A Rare and Unreported Complication

Ashok N Johari, Rashid Anjum

Keywords : Arthrogryposis multiplex congenita, Case report, Complication, Congenital talipes equinovarus, External fixation, Joshi's external stabilization system, Metatarsal lengthening

Citation Information : Johari AN, Anjum R. Inadvertent Metatarsal Lengthening and Hallux Valgus Associated with JESS in a Case of AMC: A Rare and Unreported Complication. J Foot Ankle Surg Asia-Pacific 2024; 11 (1):42-45.

DOI: 10.5005/jp-journals-10040-1323

License: CC BY-NC 4.0

Published Online: 30-12-2023

Copyright Statement:  Copyright © 2024; The Author(s).


Background: External fixators provide a flexible approach for addressing intricate foot deformities such as clubfoot, particularly in situations involving inflexible or recurrent deformities, neglected cases, or deformities associated with neuromuscular conditions. Case description: A 10-year-old patient of arthrogryposis multiplex congenita (AMC) with congenital talipes equinovarus (CTEV) undergoing treatment with Joshi's external stabilization system (JESS) presented with inadvertent metatarsal lengthening with hallux valgus. The complication was treated by a metatarsal shortening osteotomy. Conclusion: JESS is frequently used to treat relapsed, recurrent, and rigid clubfeet including cavovarus foot deformities seen in AMC. This method of differential distraction has shown promising results with fewer complications than soft tissue releases. The reported complications include pin tract infection, loosening of pins, wire cut through, flexion of toes, and recurrence; however, the present complication of inadvertent metatarsal lengthening has not yet been described.

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