{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:40:00Z","timestamp":1790221200271,"version":"4.1.0"},"reference-count":77,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2014,10,17]],"date-time":"2014-10-17T00:00:00Z","timestamp":1413504000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Syndesmosis fixation of Lauge-Hansen SER IV, Weber B ankle fractures is controversial. This study compared a matched pair of SER IV patients with stress proven syndesmotic injuries with the same number without stress proven syndesmotic injury in terms of functional, pain, and radiologic result.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The study was based on a RCT-study comparing syndesmotic transfixation to no fixation in SER IV (Weber B)\u2013type ankle fractures. Twenty-four patients with a syndesmosis injury found on the intraoperative 7.5 Nm standardized external rotation test were compared to 24 patients with a stable syndesmosis. The pairs were matched by fracture morphology, sex, and age. The primary outcome measure was ankle function as assessed by the Olerud\u2013Molander score. Weight-bearing plain radiographs and 3T MRI of the injured ankle were used to assess ankle joint congruity and osteoarthritis, according to Kellgren-Lawrence classification and cartilage defects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The Olerud\u2013Molander score was 86 in syndesmosis injury patients and 90 in patients with normal syndesmosis ( P = .28). The incidence of ankle joint osteoarthritis on plain radiographs was not significantly different between the groups (Grade I 5% vs 21%; Grade II 86% vs 75%; Grade III 9% vs 4%; P = .34). MRI scans showed TC joint cartilage defects in 54% of the patients: 12 (56%) in the syndesmosis injury group vs 13 (54%) in the group without syndesmosis injury ( P &gt; .9).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>After 4 to 6 years of follow-up, clinical and radiologic outcome were not different in patients with syndesmosis injury compared to patients with stable syndesmosis in SER IV (Weber B)\u2013type ankle fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Prognostic Level II, comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1071100714551788","type":"journal-article","created":{"date-parts":[[2014,10,18]],"date-time":"2014-10-18T00:29:06Z","timestamp":1413592146000},"page":"180-187","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":34,"title":["Effect of Syndesmosis Injury in SER IV (Weber B)\u2013Type Ankle Fractures on Function and Incidence of Osteoarthritis"],"prefix":"10.1177","volume":"36","author":[{"given":"Tero","family":"Kortekangas","sequence":"first","affiliation":[{"name":"Division of Orthopedic and Trauma Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tapio","family":"Flinkkil\u00e4","sequence":"additional","affiliation":[{"name":"Division of Orthopedic and Trauma Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaakko","family":"Niinim\u00e4ki","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sannamari","family":"Lepoj\u00e4rvi","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasi","family":"Ohtonen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oulu University Hospital, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olli","family":"Savola","sequence":"additional","affiliation":[{"name":"Omasairaala, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harri","family":"Pakarinen","sequence":"additional","affiliation":[{"name":"Division of Orthopedic and Trauma Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,10,17]]},"reference":[{"key":"bibr1-1071100714551788","volume-title":"Reliability, construct validity and reference values in the Finnish general population [English summary]","author":"Aalto AM","year":"1999"},{"key":"bibr2-1071100714551788","doi-asserted-by":"publisher","DOI":"10.3109\/17453678508994329"},{"key":"bibr3-1071100714551788","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.94B11.28662"},{"key":"bibr4-1071100714551788","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000129152.81015.ad"},{"key":"bibr5-1071100714551788","doi-asserted-by":"publisher","DOI":"10.1080\/00016470310013969"},{"key":"bibr6-1071100714551788","first-page":"563","author":"Bhandari M","year":"2012","journal-title":"One"},{"key":"bibr7-1071100714551788","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198971100-00014"},{"key":"bibr8-1071100714551788","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2009.0481"},{"key":"bibr9-1071100714551788","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(85)90145-9"},{"key":"bibr10-1071100714551788","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.77B3.7744931"},{"key":"bibr11-1071100714551788","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-195638040-00005"},{"key":"bibr12-1071100714551788","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2009.0292"},{"key":"bibr13-1071100714551788","doi-asserted-by":"publisher","DOI":"10.3109\/17453679809002355"},{"key":"bibr14-1071100714551788","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e31822c4ea5"},{"key":"bibr15-1071100714551788","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000052935.71325.30"},{"key":"bibr16-1071100714551788","doi-asserted-by":"publisher","DOI":"10.1177\/107110079701800811"},{"key":"bibr17-1071100714551788","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e3181b1542c"},{"key":"bibr18-1071100714551788","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200605000-00007"},{"key":"bibr19-1071100714551788","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-009-0809-4"},{"key":"bibr20-1071100714551788","unstructured":"Fleiss JL. 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