{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T13:12:16Z","timestamp":1790860336859,"version":"4.1.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Establish baseline rates of and risk factors for reoperation within 1 or 2 years of ankle open reduction internal fixation (ORIF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective, population-based cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Two hundred two hospitals in Ontario, Canada (approximate population 13.6 million in 2014).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients\/Participants:<\/jats:title>\n                    <jats:p>Forty five thousand four hundred forty-four patients who underwent ankle ORIF performed by 710 different surgeons between January 1, 1994, and December 31, 2011.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measurements:<\/jats:title>\n                    <jats:p>Intermediate-term reoperation because of isolated implant removal, repeat ORIF, irrigation and debridement (I&amp;D) for infection, or amputation. Multivariable logistic regression related potential prognostic factors (patient, provider, and injury) to reoperation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There were 8906 patients who underwent at least one subsequent operation (19.6%). The most common procedure was isolated implant removal (18.1%); odds of removal being higher for females [odds ratio (OR), 1.53; 95% confidence interval (CI), 1.45\u20131.62;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001]. N = 674 patients (1.5%) underwent reoperation for another reason. The odds of repeat ORIF and I&amp;D infection were greater for open fractures (OR 2.17; 95% CI, 1.22\u20133.86;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.008 and OR 3.12; 95% CI, 1.94\u20135.03;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Odds of amputation was highest for diabetics (OR 7.42; 95% CI, 3.73\u201314.86;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Isolated implant removal accounts for the vast majority of intermediate-term reoperations after ankle ORIF. Reoperation for other reasons (repeat ORIF, I&amp;D, or amputation) was extremely rare, even among the highest risk patients. Concerns regarding reoperation for these reasons should not preclude operative treatment in any patient, provider, or injury group we considered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/bot.0000000000000920","type":"journal-article","created":{"date-parts":[[2017,6,13]],"date-time":"2017-06-13T10:51:02Z","timestamp":1497351062000},"page":"e315-e320","source":"Crossref","is-referenced-by-count":51,"title":["Rate of and Risk Factors for Intermediate-Term Reoperation After Ankle Fracture Fixation: A Population-Based Cohort Study"],"prefix":"10.1097","volume":"31","author":[{"given":"Daniel","family":"Pincus","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Toronto, Toronto, ON, Canada;"},{"name":"Institute for Clinical Evaluative Sciences, Toronto, ON, Canada;"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Veljkovic","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of British Columbia, Vancouver, BC, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Zochowski","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Toronto, Toronto, ON, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nizar","family":"Mahomed","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Toronto, Toronto, ON, Canada;"},{"name":"Institute for Clinical Evaluative Sciences, Toronto, ON, Canada;"},{"name":"Arthritis Program, University Health Network, Toronto Western Hospital, Toronto, ON, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darrell","family":"Ogilivie-Harris","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Toronto, Toronto, ON, Canada;"},{"name":"Arthritis Program, University Health Network, Toronto Western Hospital, Toronto, ON, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Wasserstein","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Toronto, Toronto, ON, Canada;"},{"name":"Sunnybrook Health Sciences Centre & Sunnybrook Research Institute, Toronto, ON, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230828","first-page":"90","article-title":"Surgical treatment of malleolar fractures. 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