Treatments of complex foot deformities often need use of special external fixators to treat various deformities of multiplaner directions and contractures of ankle and foot joints. In severe cases the best choice is use external hinge distraction system to restore function of joints, treat short foot, and correct deformity.

Simple, small, mobile hinges/SLDF 2/was modified for the treatment.

From 1995 to 2007 we treated 160 cases to severe foot deformities with congenital clubfoot, neuromuscular deformities and posttraumatic deformities age between 3 to 60 years with the new modified system.

In some cases the treatment was combined with lengthening and axial correction of the lower leg if needed. The average time for correction is 4 to 6 week’s followings by 1–3 months of fixation to keep the final correction. A special orthosis is needed after removal of the fixation devices for another 6 months.

Complications were mostly superficial Pin infection, loosening of wires, no nerve or vascular damage and no thrombosis was seen. In all cases a plantigrade foot was achieved with some stiffness of the joints in neuromuscular diseases.

The walking ability was in most cases much better due to plantigrade correction; enable the patient to walk without any aid accept orthopedic shoes. The satisfaction rate of all patients was very good; some of the patients were abele to wake first time due to the correction.

The use of external fixation is an ideal treatment in complex congenital or posttraumatic foot deformities to achieve good correction, good functional and cosmetic result with a tolerable system.