Skewfoot Deformity: State of the Art

<b>Background</b>: Skewfoot, also known as Z-foot, is a rare and complex deformity characterized by a combination of forefoot adduction and hindfoot valgus, resulting in a “Z” shape. Due to its rarity, diagnostic criteria and standardized treatment guidelines are lacking. This scoping re...

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Main Authors: Antonio Mazzotti, Federico Sgubbi, Alberto Arceri, Gianmarco Di Paola, Elena Artioli, Simone Ottavio Zielli, Lorenzo Marcucci, Nicola Guindani, Cesare Faldini, Maurizio De Pellegrin
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/6/760
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author Antonio Mazzotti
Federico Sgubbi
Alberto Arceri
Gianmarco Di Paola
Elena Artioli
Simone Ottavio Zielli
Lorenzo Marcucci
Nicola Guindani
Cesare Faldini
Maurizio De Pellegrin
author_facet Antonio Mazzotti
Federico Sgubbi
Alberto Arceri
Gianmarco Di Paola
Elena Artioli
Simone Ottavio Zielli
Lorenzo Marcucci
Nicola Guindani
Cesare Faldini
Maurizio De Pellegrin
author_sort Antonio Mazzotti
collection DOAJ
description <b>Background</b>: Skewfoot, also known as Z-foot, is a rare and complex deformity characterized by a combination of forefoot adduction and hindfoot valgus, resulting in a “Z” shape. Due to its rarity, diagnostic criteria and standardized treatment guidelines are lacking. This scoping review aims to systematically map and summarize the current knowledge regarding skewfoot. <b>Methods</b>: A comprehensive literature search of the PubMed, Cochrane Library, and Scopus databases was conducted to identify relevant articles. Patient-specific data were meticulously extracted from eligible studies and analyzed in detail. <b>Results</b>: A total of 12 studies met the inclusion criteria. Each study was independently reviewed, and data on epidemiology, etiology, clinical presentation, imaging assessment, and treatment options were extracted. <b>Conclusions</b>: The true incidence of skewfoot remains unknown. Etiology is likely multifactorial, often associated with systemic and neurological disorders. Skewfoot management ranges from conservative approaches to surgery. A medial cuneiform opening wedge osteotomy is the most used technique; however, the frequent need for additional procedures emphasizes the complexity of the deformity and the importance of a personalized approach.
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issn 2227-9067
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publishDate 2025-06-01
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spelling doaj-art-a6e83cd0b5774043a94d10130999f2572025-08-20T03:26:21ZengMDPI AGChildren2227-90672025-06-0112676010.3390/children12060760Skewfoot Deformity: State of the ArtAntonio Mazzotti0Federico Sgubbi1Alberto Arceri2Gianmarco Di Paola3Elena Artioli4Simone Ottavio Zielli5Lorenzo Marcucci6Nicola Guindani7Cesare Faldini8Maurizio De Pellegrin91st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyOrthopedic Residency Program, University of Verona, 37134 Verona, ItalyOrthopaedics and Traumatology, Papa Giovanni XXIII, 24127 Bergamo, Italy1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyOrthopaedics and Traumatology, Papa Giovanni XXIII, 24127 Bergamo, Italy<b>Background</b>: Skewfoot, also known as Z-foot, is a rare and complex deformity characterized by a combination of forefoot adduction and hindfoot valgus, resulting in a “Z” shape. Due to its rarity, diagnostic criteria and standardized treatment guidelines are lacking. This scoping review aims to systematically map and summarize the current knowledge regarding skewfoot. <b>Methods</b>: A comprehensive literature search of the PubMed, Cochrane Library, and Scopus databases was conducted to identify relevant articles. Patient-specific data were meticulously extracted from eligible studies and analyzed in detail. <b>Results</b>: A total of 12 studies met the inclusion criteria. Each study was independently reviewed, and data on epidemiology, etiology, clinical presentation, imaging assessment, and treatment options were extracted. <b>Conclusions</b>: The true incidence of skewfoot remains unknown. Etiology is likely multifactorial, often associated with systemic and neurological disorders. Skewfoot management ranges from conservative approaches to surgery. A medial cuneiform opening wedge osteotomy is the most used technique; however, the frequent need for additional procedures emphasizes the complexity of the deformity and the importance of a personalized approach.https://www.mdpi.com/2227-9067/12/6/760skewfootskew footZ-footS-shaped footserpentine foot
spellingShingle Antonio Mazzotti
Federico Sgubbi
Alberto Arceri
Gianmarco Di Paola
Elena Artioli
Simone Ottavio Zielli
Lorenzo Marcucci
Nicola Guindani
Cesare Faldini
Maurizio De Pellegrin
Skewfoot Deformity: State of the Art
Children
skewfoot
skew foot
Z-foot
S-shaped foot
serpentine foot
title Skewfoot Deformity: State of the Art
title_full Skewfoot Deformity: State of the Art
title_fullStr Skewfoot Deformity: State of the Art
title_full_unstemmed Skewfoot Deformity: State of the Art
title_short Skewfoot Deformity: State of the Art
title_sort skewfoot deformity state of the art
topic skewfoot
skew foot
Z-foot
S-shaped foot
serpentine foot
url https://www.mdpi.com/2227-9067/12/6/760
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