{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:21:37Z","timestamp":1777612897472,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2014,12,15]],"date-time":"2014-12-15T00:00:00Z","timestamp":1418601600000},"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":[[2015,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In the setting of chronic osteomyelitis following fractures about the ankle, reconstruction through bony arthrodesis may be used as a reconstructive alternative to amputation. During these cases, surgeons often avoid using internal fixation in an attempt to avoid reinfection or premature hardware failure. In this retrospective review, we analyzed the outcomes of chronic osteomyelitic patients who had an arthrodesis of the ankle using either internal or external fixation, focusing on salvage rates, infection clearance, union rates, and functional outcomes. No device was implanted into a known active infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a retrospective chart review of adult patients undergoing arthrodesis in the setting of a previously septic ankle following a traumatic injury. In each case, multiple irrigation and debridement procedures and local and systemic antibiotics were used. Infection status was determined by clinical exam, MRI, nuclear medicine studies, and ultimately bone biopsies. No fixation device was implanted in ankles with known active infections. Patients were divided into 2 cohorts: those fused with internal devices and those fused with external fixators. Thirty patients underwent a total of 32 arthrodesis procedures. Mean follow up time was 27 months (range, 6 to 144).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Nineteen fusions were performed using internal fixation; only 2 required amputations, therefore limb salvage was 90%. Fifteen were able to ambulate with or without the assistance of an orthosis (79%). Four patients experienced recurrent infection (21%) and 5 developed nonunion (26%). Of the 13 fusions performed with external fixators, only 1 required an amputation, putting limb salvage at 92%. Ten patients were able to walk with or without the assistance of an orthosis as their final functional status (77%). Two patients experienced recurrent infection (15%), and 4 went on to nonunion (31%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>When analyzing these 2 fusion methods in posttraumatic patients with previously septic ankles, with the numbers available both methods achieved similar rates of limb salvage and final functional status in these patients, as well as similar rates of infection clearance and bony union. As internal fixation is often less labor-intensive for the surgeon and more palatable for the patient postoperatively, we encourage surgeons to consider arthrodesis with internal fixation once the infection is successfully eradicated, especially in a noncompliant patient population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III, retrospective comparative series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1071100714563309","type":"journal-article","created":{"date-parts":[[2014,12,15]],"date-time":"2014-12-15T22:17:52Z","timestamp":1418681872000},"page":"547-555","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["An Analysis of 2 Fusion Methods for the Treatment of Osteomyelitis Following Fractures About the Ankle"],"prefix":"10.1177","volume":"36","author":[{"given":"Jeffrey","family":"Moore","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Rutgers New Jersey Medical School, Newark, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wayne S.","family":"Berberian","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Division of Foot and Ankle Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA"},{"name":"Hackensack University Medical Center, Hackensack, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Rutgers New Jersey Medical School, Newark, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2014,12,15]]},"reference":[{"key":"bibr1-1071100714563309","first-page":"48","volume":"65","author":"Ben Amor H","year":"1999","journal-title":"Acta Orthop Belg"},{"key":"bibr2-1071100714563309","doi-asserted-by":"crossref","unstructured":"Buchner M, Sabo D. Ankle fusion attributable to posttraumatic arthrosis: a long-term followup of 48 patients. Clin Orthop Relat Res. 2003;(406):155-164. http:\/\/dx.doi.org\/10.1097\/00003086-200301000-00025","DOI":"10.1097\/00003086-200301000-00025"},{"key":"bibr3-1071100714563309","doi-asserted-by":"crossref","unstructured":"Calori GM, Tagliabue L, Mazza E, Tibial pilon fractures: which method of treatment? Injury. 2010;41:1183-1190. http:\/\/dx.doi.org\/10.1016\/j.injury.2010.08.041","DOI":"10.1016\/j.injury.2010.08.041"},{"key":"bibr4-1071100714563309","doi-asserted-by":"publisher","DOI":"10.3109\/17453679608996671"},{"key":"bibr5-1071100714563309","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/S0891-8422(23)00387-7","volume":"7","author":"Cierny G","year":"1989","journal-title":"Clin Podiatr Med Surg"},{"key":"bibr6-1071100714563309","doi-asserted-by":"crossref","unstructured":"Colman AB, Pomeroy GC. Transfibular ankle arthrodesis with rigid internal fixation: an assessment of outcome. Foot Ankle Int. 2007;28(3):303-307. http:\/\/dx.doi.org\/10.3113\/FAI.2007.0303","DOI":"10.3113\/FAI.2007.0303"},{"key":"bibr7-1071100714563309","doi-asserted-by":"crossref","unstructured":"Dalla Paola L, Brocco E, Ceccacci T, Limb salvage in Charcot foot and ankle osteomyelitis: combined use single stage\/double stage of arthrodesis and external fixation. Foot Ankle Int. 2009;30(11):1065-1070. http:\/\/dx.doi.org\/10.3113\/FAI.2009.1065","DOI":"10.3113\/FAI.2009.1065"},{"key":"bibr8-1071100714563309","doi-asserted-by":"crossref","unstructured":"Eralp L, Kocaoglu M, Yusof NM, Bulbul M. Distal tibial reconstruction with use of a circular external fixator and an intramedullary nail. The combined technique. J Bone Joint Surg Am. 2008;89:2218-2224. http:\/\/dx.doi.org\/10.2106\/JBJS.F.01579","DOI":"10.2106\/JBJS.F.01579"},{"key":"bibr9-1071100714563309","doi-asserted-by":"publisher","DOI":"10.1177\/107110070002100506"},{"key":"bibr10-1071100714563309","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.85B7.13984"},{"key":"bibr11-1071100714563309","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2011.0940"},{"key":"bibr12-1071100714563309","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(00)00156-X"},{"key":"bibr13-1071100714563309","doi-asserted-by":"publisher","DOI":"10.1177\/107110078600700108"},{"key":"bibr14-1071100714563309","doi-asserted-by":"crossref","unstructured":"Kollig E, Esenwein SA, Muhr G, Kutscha-Lissberg F. Fusion of the septic ankle: experience with 15 cases using hybrid external fixation. 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Foot Ankle Int. 2009;30(4):353-360. http:\/\/dx.doi.org\/10.3113\/FAI.2009.0353","DOI":"10.3113\/FAI.2009.0353"},{"key":"bibr17-1071100714563309","doi-asserted-by":"publisher","DOI":"10.1177\/107110079902000805"},{"key":"bibr18-1071100714563309","doi-asserted-by":"crossref","unstructured":"Pinzur MS, Gil J, Belmares J. Treatment of osteomyelitis in Charcot foot with single-stage resection of infection, correction of deformity, and maintenance with ring fixation. Foot Ankle Int. 2012;33(12):1069-1074. http:\/\/dx.doi.org\/DOI:10.3113\/FAI.2012.1069","DOI":"10.3113\/FAI.2012.1069"},{"key":"bibr19-1071100714563309","doi-asserted-by":"crossref","unstructured":"Raikin SM, Rampuri V. An approach to the failed ankle arthrodesis. Foot Ankle Clin. 2008;13:401-416, viii. http:\/\/dx.doi.org\/10.1016\/j.fcl.2008.04.009","DOI":"10.1016\/j.fcl.2008.04.009"},{"key":"bibr20-1071100714563309","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199912000-00013"},{"key":"bibr21-1071100714563309","doi-asserted-by":"crossref","unstructured":"Thomas R, Daniels TR, Parker K. Gait analysis and functional outcomes following ankle arthrodesis for isolated ankle arthritis. J Bone Joint Surg Am. 2006;88:526-535. http:\/\/dx.doi.org\/10.2106\/JBJS.E.00521","DOI":"10.2106\/00004623-200603000-00010"},{"key":"bibr22-1071100714563309","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199274070-00012"},{"key":"bibr23-1071100714563309","doi-asserted-by":"crossref","unstructured":"Zwipp H, Rammelt S, Endres T, Heineck J. High union rates and function scores at midterm followup with ankle arthrodesis using a four screw technique. Clin Orthop Relat Res. 2010;468:958-968. http:\/\/dx.doi.org\/10.1007\/s11999-009-1074-5","DOI":"10.1007\/s11999-009-1074-5"}],"container-title":["Foot &amp; Ankle International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1071100714563309","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1071100714563309","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1071100714563309","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:24:31Z","timestamp":1777411471000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1071100714563309"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,12,15]]},"references-count":23,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2015,5]]}},"alternative-id":["10.1177\/1071100714563309"],"URL":"https:\/\/doi.org\/10.1177\/1071100714563309","relation":{},"ISSN":["1071-1007","1944-7876"],"issn-type":[{"value":"1071-1007","type":"print"},{"value":"1944-7876","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,12,15]]}}}