{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:23:51Z","timestamp":1777613031572,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T00:00:00Z","timestamp":1682640000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Salvage surgery for a nonunion around the ankle is challenging. Poor bone stock, stiffness, scarring, previous (or persistent) infection, and a compromised soft tissue envelope are common in these patients. We describe 15 cases that underwent blade plate fixation as salvage for a nonunion around the ankle, including patient\/nonunion characteristics, Nonunion Scoring System (NUSS), surgical technique, healing rate, complications, and long-term follow-up with 2 patient-reported outcome measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a retrospective case series from a level 1 trauma referral center. We included all patients that underwent blade plate fixation for a long-standing nonunion of the distal tibia, talus, or failed subtalar fusion. All patients had autogenous bone grafting, including 14 with posterior iliac crest grafts and 2 with femoral reamer irrigator aspirator grafting. Median follow-up was 24.4\u2009months (interquartile range [IQR], 7.7-40). Main outcome measures were (time to) union, and functional outcomes using the 36-item Short Form Health Survey (SF-36) physical component summary (PCS) and mental component summary (MCS), and the Foot and Ankle Outcome Score (FAOS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We included 15 adults with a median age of 58\u2009years (IQR, 54-62). The median NUSS score at the time of index surgery was 46 (IQR, 34-54). Union was achieved after the index procedure in 11 of 15 patients. Additional surgery was performed in 4 of 15 patients. Union was achieved in all patients at a median of 4.2\u2009months (IQR, 2.9-11). The median score for the PCS was 38 (IQR, 34-48, range 17-58, P\u2009=\u2009.009), for the MCS 52 (IQR, 45-60, range 33-62, P\u2009=\u2009.701), and for the FAOS 73 (IQR, 48-83).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this series, our use of blade plate fixation with autogenous grafting was an effective method for managing a nonunion around the ankle allowing for alignment correction, stable compression and fixation, union, and fair patient-reported outcome scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level IV, therapeutic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10711007231165303","type":"journal-article","created":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T08:56:43Z","timestamp":1682672203000},"page":"516-527","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Blade Plate With Autogenous Bone Grafting to Salvage Peri Ankle Nonunions"],"prefix":"10.1177","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4574-8085","authenticated-orcid":false,"given":"Mees Paulus","family":"Emmelot","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC location Meibergdreef, Amsterdam, the Netherlands"},{"name":"Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert Kaspar","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC location Meibergdreef, Amsterdam, the Netherlands"},{"name":"Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stein Jasper","family":"Janssen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC location Meibergdreef, Amsterdam, the Netherlands"},{"name":"Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Kloen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC location Meibergdreef, Amsterdam, the Netherlands"},{"name":"Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,4,28]]},"reference":[{"key":"bibr1-10711007231165303","doi-asserted-by":"publisher","DOI":"10.1016\/s0895-4356(98)00097-3"},{"key":"bibr2-10711007231165303","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-018-9519-7"},{"key":"bibr3-10711007231165303","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2008.0914"},{"key":"bibr4-10711007231165303","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.305.6846.160"},{"key":"bibr5-10711007231165303","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000736"},{"key":"bibr6-10711007231165303","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2014.10.030"},{"key":"bibr7-10711007231165303","doi-asserted-by":"publisher","DOI":"10.1177\/1071100714544521"},{"key":"bibr8-10711007231165303","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200304000-00031"},{"key":"bibr9-10711007231165303","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2010.0511"},{"key":"bibr10-10711007231165303","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S91532"},{"key":"bibr11-10711007231165303","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-014-2607-4"},{"key":"bibr12-10711007231165303","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-016-4955-4"},{"key":"bibr13-10711007231165303","doi-asserted-by":"publisher","DOI":"10.1177\/1938640014565046"},{"key":"bibr14-10711007231165303","first-page":"15","volume":"268","author":"Gruen 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