{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T21:16:20Z","timestamp":1792185380998,"version":"4.4.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To evaluate long-term clinical and radiographic outcomes after surgical fixation of unstable ankle fractures.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Prospective follow-up study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Academic medical center with 2 Level-I trauma centers and a tertiary care center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients:<\/jats:title>\n            <jats:p>One hundred forty-one patients who underwent surgical repair of an unstable ankle fracture.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Intervention:<\/jats:title>\n            <jats:p>Open reduction internal fixation of an unstable ankle fracture.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main Outcome Measurements:<\/jats:title>\n            <jats:p>Short Musculoskeletal Function Assessment (SMFA) scores and radiographic outcomes based on the van Dijk criteria at a mean of 11.6 years follow-up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Of the 281 patients meeting the inclusion criteria for this study, follow-up data were obtained from 141 patients (50%), at a mean of 11.6 years after surgery. Overall, mean long-term SMFA scores were improved when compared with scores at 1 year. The American Society of Anesthesiologists class 1 or 2 was found to be a significant predictor of recovery based on SMFA scores. Sixty-three percent of follow-up radiographs demonstrated evidence of radiographic arthritis, including 31% with mild osteoarthritis, 22% with moderate osteoarthritis, and 10% with severe osteoarthritis. Fracture dislocation at injury was found to be a significant predictor of radiographic posttraumatic osteoarthritis at latest follow-up. One patient (0.7%) underwent a tibiotalar fusion secondary to symptomatic posttraumatic arthrosis. One patient (0.7%) underwent total ankle replacement due to severe osteoarthritis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Our data indicate that over a decade after ankle fracture fixation, most of the patients are doing well. Despite the presence of radiographic arthritis in 63% of patients, few experience pain or have restrictions in function, and mean long-term functional outcome scores are improved when compared with scores at 1 year. Patients undergoing operative fixation of unstable ankle fractures can anticipate functional outcomes that are maintained over time.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000000571","type":"journal-article","created":{"date-parts":[[2016,3,19]],"date-time":"2016-03-19T16:47:32Z","timestamp":1458406052000},"page":"e236-e241","source":"Crossref","is-referenced-by-count":52,"title":["Outcomes Over a Decade After Surgery for Unstable Ankle Fracture: Functional Recovery Seen 1 Year Postoperatively Does Not Decay With Time"],"prefix":"10.1097","volume":"30","author":[{"given":"Deirdre K.","family":"Regan","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Joint Diseases, NYU Langone Medical Center, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Gould","sequence":"additional","affiliation":[{"name":"UAB Department of Orthopaedic Surgery, UAB Orthopaedic Clinic, Birmingham, AL; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Manoli","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Joint Diseases, NYU Langone Medical Center, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth A.","family":"Egol","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Joint Diseases, NYU Langone Medical Center, New York, NY;"},{"name":"Department of Orthopaedic Surgery, Jamaica Hospital Medical Center, Jamaica, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R2-20230828","doi-asserted-by":"crossref","first-page":"142","DOI":"10.2106\/00004623-199501000-00020","article-title":"Fractures about the ankle","volume":"77","author":"Michelson","year":"1995","journal-title":"J Bone Joint Surg Am."},{"key":"R3-20230828","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/j.injury.2006.04.130","article-title":"Epidemiology of adult fractures: a review","volume":"37","author":"Court-Brown","year":"2006","journal-title":"Injury"},{"key":"R4-20230828","doi-asserted-by":"crossref","first-page":"974","DOI":"10.2106\/00004623-200605000-00007","article-title":"Predictors of short-term functional outcome following ankle fracture surgery","volume":"88","author":"Egol","year":"2006","journal-title":"J Bone Joint Surg Am."},{"key":"R5-20230828","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1097\/BOT.0b013e3181b1542c","article-title":"Outcome after unstable ankle fracture: effect of syndesmotic stabilization","volume":"24","author":"Egol","year":"2010","journal-title":"J Orthop Trauma."},{"key":"R6-20230828","doi-asserted-by":"crossref","first-page":"728","DOI":"10.3113\/FAI.2009.0728","article-title":"Functional outcome after operatively treated ankle fractures in the elderly","volume":"30","author":"Davidovitch","year":"2009","journal-title":"Foot Ankle Int."},{"key":"R7-20230828","doi-asserted-by":"crossref","first-page":"292","DOI":"10.3113\/FAI.2009.0292","article-title":"Return to sports following operatively treated ankle fractures","volume":"30","author":"Colvin","year":"2009","journal-title":"Foot Ankle Int."},{"key":"R8-20230828","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.2106\/00004623-200707000-00005","article-title":"Are outcomes of bimalleolar fractures poorer than those of lateral malleolar fractures with medial ligamentous injury?","volume":"89","author":"Tejwani","year":"2007","journal-title":"J Bone Joint Surg Am."},{"key":"R9-20230828","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1001\/archsurg.1950.01250010980011","article-title":"Fractures of the ankle. 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