Circular External Fixation Use Among Orthopaedic Foot and Ankle Surgeons: A National Survey Study

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Podiatric Medicine

Background:

• Circular external fixators (CEFs) offer safety and versatility but face underutilization.
• Limited data exists on contemporary CEF usage and adoption barriers.

Purpose of the Study:

• Estimate current CEF use among AOFAS members.
• Identify barriers hindering CEF adoption.
• Propose solutions to increase CEF utilization.

Main Methods:

• A multibranched survey was distributed to active AOFAS members.
• Data collected on demographics, training, CEF use, opinions, and barriers.
• Statistical analyses included descriptive statistics, chi-squared, and t-tests.

Main Results:

• 27.81% of respondents do not use CEFs, despite 94.08% recognizing their importance.
• Lack of residency exposure significantly predicts lower CEF usage.
• Common uses include Charcot neuroarthropathy, infection, and deformity correction.
• Nonusers cite concerns with operative time, postoperative burden, and management confidence.

Conclusions:

• Perceived operative time, postoperative burden, and management confidence are key barriers to CEF use.
• Enhanced training, mentorship, and non-industry courses can facilitate greater CEF adoption.