{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:13:46Z","timestamp":1777659226992,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2019,8,19]],"date-time":"2019-08-19T00:00:00Z","timestamp":1566172800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Retrospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To analyze the clinical and radiological outcomes of lower limb fractures following surgical treatment in patients with chronic spinal cord injury (SCI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Between January 2003 and December 2015, 102 chronic SCI patients with a lower limb fracture were surgically treated at our hospital. A total of 58 patients met the inclusion criteria and were recruited for final analysis. Patients with 2-stage procedure or incomplete clinical records with lost-to-follow-up were excluded from the study. Patients were divided into 2 groups (group 1= internal fixation; group 2 = external fixation). Primary outcome measures were to identify the number of nonunions via Kaplan-Meier analysis and the time to bone consolidation. The diagnosis of a pseudarthrosis was made after more than 180 days of consolidation time. Considering the Kaplan-Meier analysis, pseudarthrosis was interpreted as treatment failure. Secondary outcome measure was to evaluate the complication rate with special focus on heterotopic ossification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 58 chronic SCI patients with closed bone fractures were included in this study. Fifty-two fractures (88%) were simple and 7 (12%) were complex (type C) fractures according to AO classification. The majority of patients (34 cases, 59%) developed femur fractures followed by 24 tibial fractures (41%). Seventeen patients received an external (29%) and 41 an internal fixation (71%). Bone consolidation was reported in 31 patients (53%) with a mean time interval of bone consolidation after 97 days (range from 45 to 160 days; SD = 30). The reported nonunion (pseudarthrosis) rate was 47%. Comparing the internal group (n = 15 patients) versus the external group (n = 14), we could not find any significant difference ( P = .939) concerning the bone consolidation time. The Kaplan-Meier analysis showed a 75% cumulative survivorship at 120 days (internal group) versus 111 days (external group). Most common postoperative complications occurred in the internal fixation group with Wound infections being predominantly observed (10%), followed by heterotopic ossifications (8%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our results show that surgical treatment of lower limb fractures in chronic SCI patients is a challenging treatment with a high pseudarthrosis rate in both groups. The complication rate seems to be lower in the patients treated with external fixation. As a clinical recommendation, longer implants should be used for a stable osteosynthesis since SCI patients seem to have a higher load on the osteosynthesis material due to missing sensomotoric feedback.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2192568219871019","type":"journal-article","created":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T01:26:51Z","timestamp":1566264411000},"page":"715-719","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical and Radiological Outcomes After Surgical Treatment of Lower Limb Fractures in Patients With Spinal Cord Injury"],"prefix":"10.1177","volume":"10","author":[{"given":"Lars","family":"Ung","sequence":"first","affiliation":[{"name":"BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2421-501X","authenticated-orcid":false,"given":"Malte","family":"Ohlmeier","sequence":"additional","affiliation":[{"name":"BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birger","family":"Jettkant","sequence":"additional","affiliation":[{"name":"BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis","family":"Grasm\u00fccke","sequence":"additional","affiliation":[{"name":"BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirko","family":"Aach","sequence":"additional","affiliation":[{"name":"BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renate","family":"Meindl","sequence":"additional","affiliation":[{"name":"BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Volkmar","family":"Nicolas","sequence":"additional","affiliation":[{"name":"BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas A.","family":"Schildhauer","sequence":"additional","affiliation":[{"name":"BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa","family":"Citak","sequence":"additional","affiliation":[{"name":"BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, 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