Horsch Axel, Klotz Matthias C M, Platzer Hadrian, Seide Svenja, Zeaiter Nancy, Ghandour Maher
Department of Orthopedics and Trauma Surgery, Heidelberg University Hospital, 69118 Heidelberg, Germany.
Marienkrankenhaus Soest, Orthopedics and Trauma Surgery, 59494 Soest, Germany.
J Clin Med. 2021 Sep 13;10(18):4128. doi: 10.3390/jcm10184128.
Equinus is a common foot deformity in patients with cerebral palsy (CP). However, its prevalence is scarcely reported in the literature. Therefore, we conducted this review to estimate the prevalence of equinus foot in CP.
Eight databases were searched. Our primary outcome was the prevalence of equinus foot in CP patients. Subgroup analysis was conducted based on study design, the laterality of CP, and whether equinus foot was defined or not.
The prevalence of equinus foot in CP was 93% (95% CI: 71-99). The prevalence was 99% (95% CI: 55-100), 96% (95% CI: 57-100), and 65% (95% CI: 37-86) in unilateral, both, and bilateral CP, respectively. Based on study design, equinus foot prevalence was 92% (95% CI: 34-100) in case series and 62% (95% CI: 47-74) in cohort studies. Four studies reported definition criteria for equinus foot, with a pooled prevalence rate of equinus foot of 99% (95% CI: 36-100) compared to a rate of 89% (95% CI: 59-98) among studies that lacked a definition criterion.
This is the first meta-analysis to address the prevalence of equinus foot in CP patients. Although its prevalence is very high, our findings should be interpreted with caution due to the presence of multiple limitations, such as the lack of standardized definition criteria for equinus foot, the inappropriate study design, the wide confidence interval of equinus foot rate, and the small number of studies investigating it as a primary outcome.
马蹄足是脑瘫（CP）患者常见的足部畸形。然而，其患病率在文献中鲜有报道。因此，我们进行了这项综述以估计CP患者中马蹄足的患病率。
检索了八个数据库。我们的主要结局是CP患者中马蹄足的患病率。基于研究设计、CP的患侧以及是否定义了马蹄足进行亚组分析。
CP患者中马蹄足的患病率为93%（95%置信区间：71 - 99）。单侧、双侧和双侧CP中马蹄足的患病率分别为99%（95%置信区间：55 - 100）、96%（95%置信区间：57 - 100）和65%（95%置信区间：37 - 86）。基于研究设计，病例系列中马蹄足患病率为92%（95%置信区间：34 - 100），队列研究中为62%（95%置信区间：47 - 74）。四项研究报告了马蹄足的定义标准，定义了马蹄足的研究中其合并患病率为99%（95%置信区间：36 - 100），而缺乏定义标准的研究中该患病率为89%（95%置信区间：59 - 98）。
这是第一项针对CP患者中马蹄足患病率的荟萃分析。尽管其患病率非常高，但由于存在多种局限性，如缺乏马蹄足的标准化定义标准、研究设计不当、马蹄足患病率的置信区间较宽以及将其作为主要结局进行研究的数量较少，我们的研究结果应谨慎解读。
