{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:16:16Z","timestamp":1777612576913,"version":"3.51.4"},"reference-count":13,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:00:00Z","timestamp":1551225600000},"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":[[2019,6]]},"abstract":"\n Background:<\/jats:title>\n Evidence on the management of and outcomes from periprosthetic fractures about a total ankle replacement (TAR) are limited. The purpose of this study was to develop an algorithm for the management of patients with postoperative periprosthetic fractures about a TAR.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This was a retrospective analysis of patients undergoing a TAR from 2007 through 2017 with a subsequent periprosthetic fracture >4 weeks from index surgery. Implant stability was defined radiographically and intraoperatively where appropriate. Univariate and multivariate analyses were used to identify differences in outcomes. Thirty-two patients were identified with a remote TAR periprosthetic fracture with an average follow-up of 26 months (range, 3-104 months).<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Most fractures were located about the medial malleolus (62.5%); the majority of fractures (75%) were deemed to have stable implants. Fractures of the talus always had unstable implants and always required revision TAR surgery (100%,\n P<\/jats:italic>\n = .0002). There was no difference in patient-reported outcomes between stable and unstable fractures at an average of 36 months. In a multivariate analysis, fracture location (talus), less time to fracture, and implant type were found to be predictive of unstable implants (\n P<\/jats:italic>\n < .001). Implant stability was independently associated with the need for revision surgery (\n P<\/jats:italic>\n < .049). Nonoperative treatment was independently associated with treatment failure (\n P<\/jats:italic>\n < .001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The majority of stable fractures about a TAR required operative fixation. Management with immobilization was fraught with a high rate of subsequent surgical intervention. We found that fractures about the talus required revision TAR surgery or arthrodesis.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n Level III, retrospective cohort study.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/1071100719834542","type":"journal-article","created":{"date-parts":[[2019,2,28]],"date-time":"2019-02-28T01:50:47Z","timestamp":1551318647000},"page":"615-621","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["Algorithm for Management of Periprosthetic Ankle Fractures"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0704-1529","authenticated-orcid":false,"given":"Alexander L.","family":"Lazarides","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Duke University Medical Center, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler J.","family":"Vovos","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Duke University Medical Center, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gireesh B.","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Duke University Medical Center, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James K.","family":"DeOrio","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Duke University Medical Center, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark E.","family":"Easley","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Duke University Medical Center, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James A.","family":"Nunley","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Duke University Medical Center, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel B.","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Duke University Medical Center, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,2,27]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.M.01386"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100718799102."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e31821b8c28"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200205000-00002"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.F.01299"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200709000-00002"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-009-0971-y"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.L.00572"},{"issue":"424","key":"e_1_3_2_10_2","first-page":"104","article-title":"Malleolar fracture after total ankle arthroplasty: a comparison of two designs","volume":"2004","author":"McGarvey WC","unstructured":"McGarvey WC, Clanton TO, Lunz D. Malleolar fracture after total ankle arthroplasty: a comparison of two designs. Clin Orthop Relat Res. 2004(424):104-110.","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110070302400102"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2009.0579"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20160427-12"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.97B7.34871"}],"container-title":["Foot & Ankle International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1071100719834542","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1071100719834542","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1071100719834542","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:23:21Z","timestamp":1777411401000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1071100719834542"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,27]]},"references-count":13,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1177\/1071100719834542"],"URL":"https:\/\/doi.org\/10.1177\/1071100719834542","relation":{},"ISSN":["1071-1007","1944-7876"],"issn-type":[{"value":"1071-1007","type":"print"},{"value":"1944-7876","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,27]]}}}