{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T07:06:04Z","timestamp":1782889564312,"version":"3.54.5"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2019,12,1]],"date-time":"2019-12-01T00:00:00Z","timestamp":1575158400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To assess clinical and functional outcomes after open versus closed ankle fracture.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Retrospective comparative study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Location:<\/jats:title>\n            <jats:p>Level 1 Trauma Center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients\/Participants:<\/jats:title>\n            <jats:p>1303 patients treated for ankle fractures (Weber B and C) between 2003 and 2015. One hundred sixty-five patients (12.7%) presented with open fracture and 1138 (87.3%) with closed fracture.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Intervention:<\/jats:title>\n            <jats:p>Surgical or conservative management of ankle fracture.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main Outcome Measure:<\/jats:title>\n            <jats:p>Rates of complications and reoperations. Patient-reported functional outcomes were assessed with the Foot Function Index (FFI) and Short Musculoskeletal Function Assessment (SMFA), after a minimum of 12 months.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Mean age was 46 years and 49% of patients were male. Higher mean age was associated with open injuries (51 vs 45 years, <jats:italic toggle=\"yes\">P<\/jats:italic>\u200a&lt;\u200a0.001), and fractures were increasingly open with aging. Open fractures were associated with high-energy mechanisms: 44% following motor vehicle or motorcycle collisions, although the majority of open fractures in patients &gt;65 years occurred after ground-level fall. Complications occurred more often after open fracture (33% vs 11%) and necessitated more secondary procedures (19% vs. 7%), both <jats:italic toggle=\"yes\">P<\/jats:italic>\u200a&lt;\u200a0.001. Multivariate regression analysis identified open fracture as a predictor of complications and of worse scores on the activity categories of both the FFI and SMFA.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>Open fractures occurred more often after high energy mechanisms, and were generally more complex than closed fractures. Advanced age was common among open fracture patients, likely contributing to higher complication and secondary procedure rates. Greater morbidity after open ankle fractures was associated with minor differences on activity functions of the FFI and SMFA.<\/jats:p>\n            <jats:p>\n                                 <jats:bold>Level of Evidence<\/jats:bold>: Level 3, prognostic<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/oi9.0000000000000042","type":"journal-article","created":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T16:19:21Z","timestamp":1575303561000},"page":"e042","source":"Crossref","is-referenced-by-count":32,"title":["Open ankle fractures are associated with complications and reoperations"],"prefix":"10.1097","volume":"2","author":[{"given":"Natasha M.","family":"Simske","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan A.","family":"Audet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Yeon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather A.","family":"Vallier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,12]]},"reference":[{"key":"R1-20230823","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1007\/s00402-014-2140-3","article-title":"Open ankle fractures: who gets them and why?","volume":"135","author":"Bugler","year":"2015","journal-title":"Arch Orthop Trauma Surg."},{"key":"R2-20230823","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":"R3-20230823","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1053\/j.jfas.2014.03.011","article-title":"Epidemiology of foot and ankle fractures in the United States: an analysis of national trauma data bank (2007 to 2011)","volume":"53","author":"Shibuya","year":"2014","journal-title":"J Foot Ankle Surg."},{"key":"R4-20230823","doi-asserted-by":"crossref","first-page":"959","DOI":"10.3113\/FAI.2010.0959","article-title":"Immediate internal fixation of open ankle fractures","volume":"31","author":"Hong-Chuan","year":"2010","journal-title":"Foot Ankle Int."},{"key":"R5-20230823","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1016\/j.injury.2015.04.015","article-title":"Contemporary demographics and complications of patients treated for open ankle fractures","volume":"46","author":"Ovaska","year":"2015","journal-title":"Injury."},{"key":"R6-20230823","doi-asserted-by":"crossref","first-page":"246","DOI":"10.5435\/00124635-200604000-00006","article-title":"The geographic incidence and treatment variation of common fractures of elderly patients","volume":"14","author":"Sporer","year":"2006","journal-title":"J Am Acad Orthop Surg."},{"key":"R7-20230823","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/S8756-3282(02)00832-3","article-title":"Increasing number and incidence of low-trauma ankle fractures in elderly people: Finnish statistics during 1970-2000 and projections for the future","volume":"31","author":"Kannus","year":"2002","journal-title":"Bone."},{"key":"R8-20230823","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/S0278-5919(20)30956-X","article-title":"The epidemiology of foot and ankle injuries in sports","volume":"7","author":"Garrick","year":"1988","journal-title":"Clin Sports Med."},{"key":"R9-20230823","first-page":"551","article-title":"Athletes\u2019 ankle injuries: diagnosis and management","volume":"34","author":"Gehrmann","year":"2005","journal-title":"Am J Orthop."},{"key":"R10-20230823","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/S8756-3282(01)00614-7","article-title":"Epidemiology of fractures in England and Wales","volume":"29","author":"Van Staa","year":"2001","journal-title":"Bone."},{"key":"R11-20230823","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/00003086-198903000-00007","article-title":"Treatment of open ankle fractures. 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