Despite advances in reconstructive surgery, salvage of mangled extremities still requires long periods of treatment with many operations that can be taxing both to the surgeon and the patient. Attempts at reconstruction of severely shattered limbs necessitate counselling with regard to the protracted course of treatment and associated morbidity as well as problems which may require abandoning of the procedure and secondary amputation. We report the successful salvage of a severely comminuted and open fracture of the tibia in a 32-year-old man.

The Surgery of resistant and relapsed club foot is always a great problem even for an experienced Orthopaedic Surgeon. Surgery on the bones in younger patient is contraindicated. The principle of differential fractional distraction technique invented by Prof. Joshi of Bombay is well accepted in many Countries. His technique using the JESS system (Joshi’s External Skeletal System) is used extensively for resistant and relapsed Club feet. In our Institute during this decade 57 feet in 45 children in the age group of one to five years were corrected using the above mentioned technique. Results were assessed as per SIMMON’S CRITERIA. 47 out of the 57 feet showed satisfactory results. Recurrence of the deformity observed in 10 feet. This study details the methodology of distraction, merits and pitfalls of the procedure.