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Peer-reviewedCC BYJournal of foot and ankle research

A Systematic Review of Complications Following Elective Foot and Ankle Surgery.

  • Lia Spencer1
  • Connor Phillips1
  • Sifat Alam1
  • Kit Ferguson1
  • Richard Feinn1
  • Douglas McHugh1
  • Ewan Kannegieter1
  1. 1Department of Medical Sciences, Frank H. Netter MD School of Medicine, Quinnipiac University, Hamden, Connecticut, USA.
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Abstract

Introduction

Complications following elective foot and ankle surgery are a significant source of morbidity and may impair recovery. Evidence is often procedure specific, limiting a broader understanding. This review aimed to synthesize complication profiles, risk factors, and mitigation strategies across elective procedures.Methods

PubMed, Scopus, and CINAHL were searched for studies published between 1 January 2020 and 30 June 2025. Eligible studies included adults undergoing elective foot and ankle surgery and reporting postoperative complications. Data were extracted on complication type, incidence, and risk factors, and synthesized narratively due to heterogeneity.Results

Nine studies (n = 20,455) were included. Complication rates varied: infection (0.3%-12.5%), wound healing problems (0.5%-10.0%), nonunion (0.8%-18.7%), hardware removal (3.8%-15.5%), nerve injury (0.2%-10.0%), pain or stiffness (0.8%-18.7%), and systemic complications (3.6%-7.4%). Consistent risk factors included diabetes, obesity, smoking, and peripheral vascular disease. Higher complication rates were associated with revision surgery, prolonged operative time, and multisegment reconstruction.Conclusion

Complications after elective foot and ankle surgery are common and multifactorial, with consistent risk patterns across procedures. These findings support improved risk stratification, targeted preoperative optimization, and structured postoperative care.

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Cite

BibTeXRIS
BibTeX
@article{spencer2026systematic,
  title = {{A Systematic Review of Complications Following Elective Foot and Ankle Surgery.}},
  author = {Lia Spencer and Connor Phillips and Sifat Alam and Kit Ferguson and Richard Feinn and Douglas McHugh and Ewan Kannegieter},
  journal = {Journal of foot and ankle research},
  year = {2026},
  month = oct,
  doi = {10.1002/jfa2.70235},
  url = {https://europepmc.org/article/MED/42894440},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - A Systematic Review of Complications Following Elective Foot and Ankle Surgery.
AU  - Lia Spencer
AU  - Connor Phillips
AU  - Sifat Alam
AU  - Kit Ferguson
AU  - Richard Feinn
AU  - Douglas McHugh
AU  - Ewan Kannegieter
PY  - 2026
DA  - 2026/10/30
JO  - Journal of foot and ankle research
DO  - 10.1002/jfa2.70235
UR  - https://europepmc.org/article/MED/42894440
AB  - Introduction  Complications following elective foot and ankle surgery are a significant source of morbidity and may impair recovery. Evidence is often procedure specific, limiting a broader understanding. This review aimed to synthesize complication profiles, risk factors, and mitigation strategies across elective procedures.Methods  PubMed, Scopus, and CINAHL were searched for studies published between 1 January 2020 and 30 June 2025. Eligible studies included adults undergoing elective foot and ankle surgery and reporting postoperative complications. Data were extracted on complication type, incidence, and risk factors, and synthesized narratively due to heterogeneity.Results  Nine studies (n = 20,455) were included. Complication rates varied: infection (0.3%-12.5%), wound healing problems (0.5%-10.0%), nonunion (0.8%-18.7%), hardware removal (3.8%-15.5%), nerve injury (0.2%-10.0%), pain or stiffness (0.8%-18.7%), and systemic complications (3.6%-7.4%). Consistent risk factors included diabetes, obesity, smoking, and peripheral vascular disease. Higher complication rates were associated with revision surgery, prolonged operative time, and multisegment reconstruction.Conclusion  Complications after elective foot and ankle surgery are common and multifactorial, with consistent risk patterns across procedures. These findings support improved risk stratification, targeted preoperative optimization, and structured postoperative care.
SN  - 1757-1146
ER  -