{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:30:49Z","timestamp":1787243449581,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,3,30]],"date-time":"2017-03-30T00:00:00Z","timestamp":1490832000000},"content-version":"vor","delay-in-days":57,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2017,2]]},"abstract":"\n Objective<\/jats:title>\n \n To compare clinical and radiographic outcomes of posterior malleolar fractures (\n PMF<\/jats:styled-content>\n ) treated with lag screws from anterior to posterior versus posterior to anterior approach.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We retrospectively analyzed 48 patients with trimalleolar fractures who underwent open reduction and internal fixation (\n ORIF<\/jats:styled-content>\n ) with either posteromedial (\n PM<\/jats:styled-content>\n ) or posterolateral (\n PL<\/jats:styled-content>\n ) approaches between January 2012 and December 2014. Fixation of the posterior malleolus was made with anteroposterior screws in 20 patients using the\n PM<\/jats:styled-content>\n approach and posteroanterior screws in 28 patients using the\n PL<\/jats:styled-content>\n approach. The American Orthopedic Foot and Ankle Society (\n AOFAS<\/jats:styled-content>\n ) scores and range of motion (\n ROM<\/jats:styled-content>\n ) of the ankle were used as the main outcome measurements, and results were evaluated at the 6\u2010month, 12\u2010month and final follow\u2010up. Postoperative radiographs and computed tomography scans were used to evaluate the residual gap\/step\u2010off. The degree of arthritis was evaluated on final follow\u2010up using Bargon criteria. Other complications were also recorded to compare the clinical outcomes of the two approaches.\n <\/jats:p>\n <\/jats:sec>\n \n Result<\/jats:title>\n \n The mean duration of follow\u2010up regardless of the approaches was 21.1 months (range, 15\u201354 months). None of the patients developed delayed union or nonunion. Functional bone healing was obtained in all patients at 10.7 weeks (range, 8\u201316 weeks). The mean\n AOFAS<\/jats:styled-content>\n scores of the\n PM<\/jats:styled-content>\n group at the postoperative 6\u2010mouth, 12\u2010month, and final follow\u2010up were 91.4 (range, 82\u2013100), 92.5 (range, 84\u2013100), and 92.9 (range, 86\u2013100), respectively. In the\n PL<\/jats:styled-content>\n group, the mean\n AOFAS<\/jats:styled-content>\n scores were 89.9 (range, 72\u2013100), 91.4 (range, 77\u2013100), and 91.9 (range, 77\u2013100), respectively. At the final follow\u2010up, the median loss of range of motion (\n ROM)<\/jats:styled-content>\n for dorsiflexion and plantaflexion were 0\u00b0(0\u00b0, 5\u00b0) and 0\u00b0(0\u00b0, 0\u00b0), respectively, in both groups. There were no significant differences between the two approaches in\n AOFAS<\/jats:styled-content>\n scores and\n ROM<\/jats:styled-content>\n of the ankle in each period postoperatively (\n P<\/jats:italic>\n > 0.05). Two patients in the\n PL<\/jats:styled-content>\n group and 1 in the\n PM<\/jats:styled-content>\n group developed Bargon grade 2 or 3 arthritis. We detected a 2\u2010mm and 3\u2010mm step\u2010off in 1 patient in the\n PM<\/jats:styled-content>\n and\n PL<\/jats:styled-content>\n groups, respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Satisfactory results were obtained by using the two approaches for fixation of posterior malleolus, and the approaches have similar clinical and radiographic outcomes. Surgeons should choose the appropriate approach based on their experience.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/os.12308","type":"journal-article","created":{"date-parts":[[2017,3,30]],"date-time":"2017-03-30T18:57:41Z","timestamp":1490900261000},"page":"69-76","source":"Crossref","is-referenced-by-count":54,"title":["Comparison of Posteromedial Versus Posterolateral Approach for Posterior Malleolus Fixation in Trimalleolar Ankle Fractures"],"prefix":"10.1111","volume":"9","author":[{"given":"Sheng","family":"Zhong","sequence":"first","affiliation":[{"name":"Graduate School Shanghai University of Traditional Chinese Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery Tianjin Hospital Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010guo","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery Tianjin Hospital Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery Tianjin Hospital Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin\u2010feng","family":"Xie","sequence":"additional","affiliation":[{"name":"Graduate School, Tianjin University of Traditional Chinese Medicine Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Shi","sequence":"additional","affiliation":[{"name":"Spine Institute, Longhua Hospital Shanghai University of Traditional Chinese Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying\u2010hua","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery Tianjin Hospital Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xian\u2010tie","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery Tianjin Hospital Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,3,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453678709146395"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200603000-00027"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453679809002355"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-198911000-00018"},{"key":"e_1_2_6_6_1","first-page":"559","volume-title":"AO Principles of Fracture Management","author":"David MH","year":"2000"},{"key":"e_1_2_6_7_1","first-page":"2147","volume-title":"Rockwood and Green's Fractures in Adults","author":"Marsh J","year":"2005"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198870090-00012"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-199209000-00014"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2009.0309"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-012-1591-9"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1071100715570895"},{"key":"e_1_2_6_13_1","first-page":"182","article-title":"Tibiotalar contact area. 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