The use of external fixation for the correction of recurrent clubfoot: a systematic review and meta-analysis. in Archives of orthopaedic and trauma surgery / Arch Orthop Trauma Surg. 2025 Feb 11;145(1):159. doi: 10.1007/s00402-025-05776-1.

2025
ASL Vercelli

Tipo pubblicazione

Systematic Review

Autori/Collaboratori (8)Vedi tutti...

Vaccalluzzo MS
University of Catania, Catania, Italy.
Testa G
University of Catania, Catania, Italy. gianpavel@hotmail.com.
Sodano A
University of Catania, Catania, Italy.

et alii...

Abstract

BACKGROUND: Recurrent clubfoot (CF) remains a challenging orthopedic condition, often requiring surgical intervention due to deformity rigidity and scarring from previous treatments. External fixation, particularly the Ilizarov technique, has emerged as a promising approach to correct recurrent and complex CF deformities. However, there is considerable variability in reported results regarding success and recurrence rates. OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the efficacy and safety of external fixation with a focus on success rates, recurrence rates, and complication profiles in patients treated for recurrent CF. METHODS: A systematic search of five databases (PubMed, Embase, Web of Science, ScienceDirect, Cochrane Library) was performed according to PRISMA guidelines. Studies evaluating external fixation for recurrent clubfoot and reporting quantitative data on success and recurrence rates were included. A total of 438 records were screened and 21 studies met the inclusion criteria. Data extraction was performed on demographic characteristics, treatment details, and outcomes. Meta-analysis was performed using a random effects model to pool success and recurrence rates. RESULTS: The review analyzed 21 studies involving 489 treated feet in 406 patients. The pooled overall success rate was 81.4% (95% CI: 74.5-88.4%), while the pooled recurrence rate was 17.7% (95% CI: 11.3-24.1%). The studies showed minimal heterogeneity (I² = 0%) in both success and recurrence rates. Complications were common, with pin tract infection being the most common (29.3%), followed by toe contractures and digital ischemia. CONCLUSIONS: External fixation is an effective approach for recurrent CF, with satisfactory success rates. However, the risk of complications underscores the need for vigilant postoperative care. The results support the use of external fixation for complex CF recurrences, but further studies are needed.

Accesso banca dati bibliografica

PMID : 39932573

DOI : 10.1007/s00402-025-05776-1

Keywords

Humans; Clubfoot/surgery; Recurrence; External Fixators; Ilizarov Technique; Treatment Outcome; Postoperative Complications/epidemiology; Clubfoot; External fixation; Ilizarov technique; Meta-analysis; Pin tract infections; Recurrence;