{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T04:15:20Z","timestamp":1791951320136,"version":"4.3.4"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,4]]},"abstract":"\n Objectives:<\/jats:title>\n To evaluate the effect of posterior bony versus ligamentous injury pattern on functional outcomes in operatively treated rotational ankle fractures.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Retrospective cohort analysis of prospective registry.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Academic Level I trauma center.<\/jats:p>\n <\/jats:sec>\n \n Patients\/Participants:<\/jats:title>\n Operatively treated supination external rotation IV and pronation external rotation IV ankle fractures.<\/jats:p>\n <\/jats:sec>\n \n Intervention:<\/jats:title>\n Lateral malleolus plate fixation with either posterior malleolus (PM) plate fixation or posterior inferior tibiofibular ligament (PITFL) repair.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measurements:<\/jats:title>\n Foot and ankle outcome scores at minimum 12 months postoperatively.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n One hundred seventy-eight fractures were treated with injury-specific anatomic fixation of a PM fracture (n = 122) or torn PITFL (n = 56). The PM group was significantly older, contained more women, and had lower mean body mass index versus the PITFL group. There was a higher rate of medial malleolar fracture in the PM group; other fracture and baseline characteristics were similar between groups. Univariate and multivariable analysis revealed no difference in foot and ankle outcome scores for any of the 5 summary domains (symptoms, pain, activities of daily living, sports, or quality of life) at the time of most recent follow-up. The median length of follow-up was 16.3 and 12.8 months in the PM and PITFL groups, respectively.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n In our cohort of ankle fractures, we have demonstrated comparable outcomes in stage IV rotational ankle fractures with and without PM fractures, indicating that the presence of a PM fracture may not result in inferior outcomes compared with ligamentous equivalent injuries if these fractures are addressed in an injury-specific manner.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bot.0000000000001104","type":"journal-article","created":{"date-parts":[[2018,2,2]],"date-time":"2018-02-02T16:42:42Z","timestamp":1517589762000},"page":"e123-e128","source":"Crossref","is-referenced-by-count":25,"title":["Comparing Functional Outcomes After Injury-Specific Fixation of Posterior Malleolar Fractures and Equivalent Ligamentous Injuries in Rotational Ankle Fractures"],"prefix":"10.1097","volume":"32","author":[{"given":"Ashley E.","family":"Levack","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Warner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth B.","family":"Gausden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Helfet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean G.","family":"Lorich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230828","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1001\/archsurg.1950.01250010980011","article-title":"Fractures of the ankle. 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