Evidence map›Paper›PMID 39932573›Full record

SynthesisArchives of orthopaedic and trauma surgery2025

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

Marco Simone Vaccalluzzo, Gianluca Testa, Andrea Sodano, Marco Sapienza, Federico Canavese, Domenico Costantino Aloj, Alessia Caldaci, Vito Pavone

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. [Ilizarov external fixation technique combined with limited osteotomy for post-traumatic equinovarus deformity].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Marco Simone VaccalluzzoUniversity of Catania, Catania, Italy.
Gianluca TestaUniversity of Catania, Catania, Italy. gianpavel@hotmail.com.
Andrea SodanoUniversity of Catania, Catania, Italy.
Marco SapienzaUniversity of Catania, Catania, Italy.
Federico CanaveseDepartment of Orthopedic and Traumatology, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, Genoa, Italy.
Domenico Costantino AlojOspedale Sant'Andrea, Vercelli, Italy.
Alessia CaldaciUniversity of Catania, Catania, Italy.
Vito PavoneUniversity of Catania, Catania, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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 (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.

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.

Indexed as

ClubfootExternal FixatorsIlizarov TechniqueHumansRecurrenceClubfootExternal fixationIlizarov techniqueMeta-analysisPin tract infectionsRecurrence

Identifiers

PMID39932573
PMCPMC11813818

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.