A PRELIMINARY REPORT OF THE COVENTRY EXPERIENCE IN THE USE OF THE UMEX SYSTEM OF EXTERNAL SKELETAL FIXATION, I N THE MANAGEMENT OF CLUB FOOT AND OTHER PAEDIATRIC FOOT DISORDERS.

Abstract

Introduction: The UMEX system of external skeletal fixation has been widely used on the Indian subcontinent since its development by Dr. B.B. Joshi of Mumbai. The system employs a method of gradual distraction with manual correction of deformity. It has applications to both the upper and lower limbs, both in Orthopaedic and Traumatic conditions.

This paper aims to introduce the system to members of B.S.C.O.S. as an alternative method of correction of the relapsed clubfoot. It has a use in other Paediatric and Adult foot deformities.

The system is light and easy to apply, and unlike some other methods of external fixation is cheap and well tolerated by patients and their parents.

Results: This paper will describe the use of the device in the first 3 patients with club foot and with 2 others, one with deformity secondary to neurological abnormality, one patient with congenital abnormality of the forefoot.

The assessment of deformity in club foot is controversial and difficult to apply to many cases. The goal of treatment is a plantigrade and supple foot, that functions well in locomotion. To date, admittedly in a small number of cases, this has been achieved following relapse from earlier surgery.

Discussion: The management of relapsed club foot and other complex foot deformities is often far from easy, and results in a stiff foot, with some residual deformity evident after repeated surgery. The UMEX system, by combining distraction with gentle manual correction, has, in our hands, been effective in restoring shape and function to the foot without the need for invasive surgery.