The use of external fixation for the correction of recurrent clubfoot: a systematic review and meta-analysis

被引:0
作者
Vaccalluzzo, Marco Simone [1 ]
Testa, Gianluca [1 ]
Sodano, Andrea [1 ]
Sapienza, Marco [1 ]
Canavese, Federico [2 ,3 ]
Aloj, Domenico Costantino [4 ]
Caldaci, Alessia [1 ]
Pavone, Vito [1 ]
机构
[1] Univ Catania, Catania, Italy
[2] IRCCS Ist Giannina Gaslini, Dept Orthoped & Traumatol, Via Gerolamo Gaslini 5, Genoa, Italy
[3] Univ Genoa, Dipartimento Sci Chirurg & Diagnost Integrate, Via Benedetto 15 N6, Genoa, Italy
[4] Osped Sant Andrea, Vercelli, Italy
关键词
Clubfoot; External fixation; Ilizarov technique; Recurrence; Pin tract infections; Meta-analysis; ADJUNCTIVE SURGICAL-PROCEDURES; TALIPES EQUINOVARUS; RELAPSED CLUBFOOT; ILIZAROV TECHNIQUE; DEFORMITIES; MANAGEMENT; ETIOLOGY; CLUBFEET; FRAME;
D O I
10.1007/s00402-025-05776-1
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
BackgroundRecurrent 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.ObjectiveThis 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.MethodsA 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.ResultsThe 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 (I-2 = 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.ConclusionsExternal 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.
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页数:13
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共 32 条
[1]   The Ilizarov method in the management of relapsed club feet [J].
Bradish, CF ;
Noor, S .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2000, 82B (03) :387-391
[2]   Clubfoot: Etiology and Treatment [J].
Brand, Richard A. .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2009, 467 (05) :1121-1123
[3]  
Burns Jeffrey K, 2004, Foot Ankle Clin, V9, P571, DOI 10.1016/j.fcl.2004.05.011
[4]   METAANALYSIS IN CLINICAL-TRIALS [J].
DERSIMONIAN, R ;
LAIRD, N .
CONTROLLED CLINICAL TRIALS, 1986, 7 (03) :177-188
[5]  
Dobbs MB, 2009, CLIN ORTHOP RELAT R, V467, P1146, DOI 10.1007/s11999-009-0734-9
[6]   Long-term follow-up of patients with clubfeet treated with extensive soft-tissue release [J].
Dobbs, MB ;
Nunley, R ;
Schoenecker, PL .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2006, 88A (05) :986-996
[7]   Correction of Residual Clubfoot Deformities in Older Children Using the Taylor Spatial Butt Frame and Midfoot Gigli Saw Osteotomy [J].
Eidelman, Mark ;
Keren, Yaniv ;
Katzman, Alexander .
JOURNAL OF PEDIATRIC ORTHOPAEDICS, 2012, 32 (05) :527-533
[8]   Correction of relapsed or neglected clubfoot using a simple Ilizarov frame [J].
El Barbary, H ;
Ghani, HA ;
Hegazy, M .
INTERNATIONAL ORTHOPAEDICS, 2004, 28 (03) :183-186
[9]  
El-Mowafi Hani, 2009, Foot Ankle Surg, V15, P3, DOI 10.1016/j.fas.2008.04.007
[10]   Ilizarov external fixation for management of severe relapsed clubfeet in older children [J].
El-Sayed, Mohamed .
FOOT AND ANKLE SURGERY, 2013, 19 (03) :177-181