{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T02:28:35Z","timestamp":1789266515626,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,3,9]],"date-time":"2017-03-09T00:00:00Z","timestamp":1489017600000},"content-version":"vor","delay-in-days":36,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81272051"],"award-info":[{"award-number":["81272051"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the characteristics and the results of realignment surgery for the treatment of malunited ankle fracture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010three patients with malunited fractures of the ankle who underwent reconstructive surgery at our hospital from January 2010 to January 2014 were reviewed. The tibial anterior surface angle (<jats:styled-content style=\"fixed-case\">TAS<\/jats:styled-content>), the tibiotalar tilt angle (<jats:styled-content style=\"fixed-case\">TTA<\/jats:styled-content>), the malleolar angle (<jats:styled-content style=\"fixed-case\">MA<\/jats:styled-content>), and the tibial lateral surface angle (<jats:styled-content style=\"fixed-case\">TLS<\/jats:styled-content>) were measured. Clinical assessment was performed with use of the American Orthopaedic Foot and Ankle Society (<jats:styled-content style=\"fixed-case\">AOFAS<\/jats:styled-content>) scale and visual analogue scale (<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>) scores, and the osteoarthritis stage was determined radiographically with the modified Takakura classification system. The Wilcoxon matched\u2010pairs test was used to analyze the difference between the preoperative and the postoperative data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean follow\u2010up was 36 months (range, 20\u201360 months). The mean age at the time of realignment surgery was 37.1 years (range, 18\u201362 years). Compared with preoperation, the <jats:styled-content style=\"fixed-case\">TAS<\/jats:styled-content> at the last follow\u2010up showed a significant increase (88.50\u00b0 \u00b1 4.47\u00b0 <jats:italic>vs<\/jats:italic>. 90.80\u00b0 \u00b1 3.49\u00b0, <jats:italic>P<\/jats:italic> = 0.0035); similar results were observed in <jats:styled-content style=\"fixed-case\">TTA<\/jats:styled-content> (1.62\u00b0 \u00b1 1.66\u00b0 <jats:italic>vs<\/jats:italic>. 0.83\u00b0 \u00b1 0.90\u00b0, <jats:italic>P<\/jats:italic> &lt; 0.01) and <jats:styled-content style=\"fixed-case\">MA<\/jats:styled-content> (82.30\u00b0 \u00b1 8.03\u00b0 <jats:italic>vs<\/jats:italic>. 78.70\u00b0 \u00b1 4.76\u00b0, <jats:italic>P<\/jats:italic> = 0.005). At the last follow\u2010up, the mean <jats:styled-content style=\"fixed-case\">AOFAS<\/jats:styled-content> score was significantly increased compared with the score at preoperation (44.5 \u00b1 13.7 <jats:italic>vs<\/jats:italic>. 78.0 \u00b1 8.9, <jats:italic>P<\/jats:italic> &lt; 0.01). Significant differences in <jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content> scores were found at the last follow\u2010up (6.76 \u00b1 1.03 <jats:italic>vs<\/jats:italic>. 2.03 \u00b1 1.21, <jats:italic>P<\/jats:italic> &lt; 0.01). There was no significant difference in the Takakura grade between the preoperation and the last follow\u2010up. One patient had increased talar tilt postsurgery; the postoperative talar tilt angle of this patient was 20\u00b0. One patient had progressive ankle osteoarthritis, and was treated by ankle joint distraction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Realignment surgery for a malunited ankle fracture can reduce pain, improve function, and delay ankle arthrodesis or total ankle replacement. Postoperative large talar tilt and advanced stages of ankle arthritis are the risk factors for the surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12312","type":"journal-article","created":{"date-parts":[[2017,3,9]],"date-time":"2017-03-09T12:26:47Z","timestamp":1489062407000},"page":"49-53","source":"Crossref","is-referenced-by-count":10,"title":["Realignment Surgery for Malunited Ankle Fracture"],"prefix":"10.1111","volume":"9","author":[{"given":"Chang\u2010jun","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Ruijin Hospital North Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Department of Orthopaedics, Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing\u2010cheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Ruijin Hospital North Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mu","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Ruijin Hospital North Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang\u2010yang","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Ruijin Hospital North Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Department of Orthopaedics, Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,3,9]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2015.09.003"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpm.2008.09.008"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2013.06.001"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2010.09.017"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2008.09.005"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2005.12.006"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpm.2004.03.001"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2011.11.007"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-010-0060-7"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2004.05.012"},{"key":"e_1_2_5_12_1","first-page":"8","article-title":"Anatomical reconstruction for malunited foot and ankle fractures","volume":"21","author":"Rammelt S","year":"2016","journal-title":"Foot Ankle Clin"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-013-1876-7"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110070302400406"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2012.0250"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00249"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/BLO.0b013e318124a462"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.88B7.17325"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2015.09.002"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.92B1.22540"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2011.0693"},{"key":"e_1_2_5_22_1","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1302\/0301-620X.77B1.7822395","article-title":"Low tibial osteotomy for osteoarthritis of the ankle. 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