A Systematic Review of Complications Following Elective Foot and Ankle Surgery.
Lia Spencer, Connor Phillips, Sifat Alam et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review synthesized complication profiles and risk factors in adults undergoing elective foot and ankle surgery. It included nine studies with 20,455 patients, published between 1 January 2020 and 30 June 2025; findings were summarized narratively because of heterogeneity. Reported complication rates varied by outcome, including infection (0.3%-12.5%), nonunion (0.8%-18.7%), and hardware removal (3.8%-15.5%). Diabetes, obesity, smoking, and peripheral vascular disease were consistent risk factors, while revision surgery, prolonged operative time, and multisegment reconstruction were associated with higher complication rates.
Key findings
- Across included studies, infection rates ranged from 0.3%-12.5%, and wound healing problems from 0.5%-10.0%.
- Nonunion rates ranged from 0.8%-18.7%; hardware removal ranged from 3.8%-15.5%.
- Diabetes, obesity, smoking, and peripheral vascular disease were consistent risk factors for complications.
- Higher complication rates were associated with revision surgery, prolonged operative time, and multisegment reconstruction.
Why it matters
The review highlights that complications span wound, bone-healing, hardware, neurologic, pain-related, and systemic outcomes, with rates varying across procedures. Recognizing recurring patient and procedural risk patterns can inform discussions of perioperative risk and support attention to optimization and follow-up, while the broad ranges caution against assuming a single complication rate applies across elective foot and ankle surgery.
What to keep in mind
Only nine studies were included, and heterogeneity required narrative synthesis, limiting direct comparison of complication rates across procedures.