{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T08:10:20Z","timestamp":1773303020638,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T00:00:00Z","timestamp":1588291200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Low\u2010energy fractures of the lower limb in patients post spinal cord injury (SCI) present significant management challenges. This is the first Australian study to review the experience from a tertiary referral SCI centre and aims to identify trends and suggest therapeutic options.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review over a 5\u2010year period in patients with SCI treated for a lower limb fragility fracture. Patient demographics, spinal injury severity scores, fracture characteristics and treatment were assessed. Time to union, length of stay and treatment\u2010related complications were also examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 38 SCI patients with 42 lower extremity fractures met inclusion criteria. Mean age was 55.7\u2009years and mean duration post\u2010SCI at fracture was 22.5\u2009\u00b1\u200912.7\u2009years. The femur (73.8%) was more commonly fractured than the lower leg (26.2%), with extra\u2010articular distal femoral fractures most prevalent (35.7%). A total of 25 (60%) fractures were managed operatively, and 17 (40%) non\u2010operatively. The majority of femoral fractures were managed with intramedullary nailing. Tibial fractures were more commonly managed non\u2010operatively. Eight cases (19.1%) experienced complications, with a significant difference between frequency of complications in non\u2010operative (35.3%) and operative (8.0%) groups; <jats:italic>P<\/jats:italic> = 0.045. All fractures united except one; time to union was shorter in patients treated surgically (13.6\u2009\u00b1\u20096.4\u2009weeks) compared to those managed non\u2010operatively (19.1\u2009\u00b1\u20098.1\u2009weeks).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lower limb fragility fractures in patients with SCI can be managed successfully via either operative or non\u2010operative measures. In this series, fewer complications and shorter time to union were found in patients managed operatively.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.15924","type":"journal-article","created":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T11:54:26Z","timestamp":1588334066000},"page":"1743-1749","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Management of lower limb fractures in patients with spinal cord injuries"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7203-8193","authenticated-orcid":false,"given":"Denis P.","family":"Koong","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Trauma Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4613-2653","authenticated-orcid":false,"given":"Michael J.","family":"Symes","sequence":"additional","affiliation":[{"name":"The Orthopaedic Research Institute and Department of Orthopaedic Surgery St George and Sutherland Clinical School, University of New South Wales Medicine  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew K.","family":"Sefton","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brahman S.","family":"Sivakumar","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hornsby Ku\u2010Ring\u2010Gai Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,5]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Spinal Cord Injury Australia 2013\u201314","author":"Tovell A","year":"2018"},{"key":"e_1_2_6_3_1","unstructured":"Northern Sydney Local Health District. 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