{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:23:59Z","timestamp":1790141039759,"version":"4.0.1"},"reference-count":22,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2019,3,20]],"date-time":"2019-03-20T00:00:00Z","timestamp":1553040000000},"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":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2019,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Ankle Charcot neuroarthropathy presents a great challenge for treatment. While conservative treatments yield poor results, arthrodesis is considered the treatment of choice for unstable Charcot ankles. There are two methods used for ankle fusion: retrograde intramedullary nail (IMN) and external fixator (EF). Literature reports inconclusive results on which method is better for arthrodesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The aim of this meta-analysis is to look for significant difference between the two techniques in terms of fusion rate and complications. Four comparative studies including 117 patients (117 interventions) were located and analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>IMN was found to yield double fusion rate than EF ( p = 0.2) with 5 weeks less time to heal ( p = 0.4). While no significance was noted for revision surgery and amputation rates, EF yielded higher rates of hardware infection ( p = 0.01) and wound infection ( p = 0.01). The IMN method seems to offer quicker and better fusion rate when compared to EF with significantly lower postoperative infection rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In the clinical context of high-risk patients such as the diabetic population, IMN technique could be a better option in the case of ulcer-free ankles\/feet or in the presence of medial\/lateral ulcers. In case of presence of plantar ulcers, EF might be a better choice to avoid the plantar approach for nail insertion. Future research with bigger sample sized and randomized studies are warranted for validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2309499019836012","type":"journal-article","created":{"date-parts":[[2019,3,21]],"date-time":"2019-03-21T00:26:18Z","timestamp":1553127978000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":26,"title":["Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy: A meta-analysis of comparative studies"],"prefix":"10.1177","volume":"27","author":[{"given":"Kaissar","family":"Yammine","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Lebanese American University Medical Center-Rizk Hospital, Achrafieh, Beirut, Lebanon"},{"name":"School of Medicine, Lebanese American University, Byblos, Lebanon"},{"name":"Center for Evidence-Based Anatomy, Sports and Orthopedic Research, Beirut, Lebanon"},{"name":"Diabeti Foot Clinic, Department of Orthopedics, Lebanese American University Medical Center-Rizk Hospital, Achrafieh, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chahine","family":"Assi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Lebanese American University Medical Center-Rizk Hospital, Achrafieh, Beirut, Lebanon"},{"name":"School of Medicine, Lebanese American University, Byblos, Lebanon"},{"name":"Center for Evidence-Based Anatomy, Sports and Orthopedic Research, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,3,20]]},"reference":[{"key":"bibr1-2309499019836012","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2012.0113"},{"key":"bibr2-2309499019836012","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2008.09.004"},{"key":"bibr3-2309499019836012","doi-asserted-by":"publisher","DOI":"10.1177\/107110070502600910"},{"key":"bibr4-2309499019836012","doi-asserted-by":"publisher","DOI":"10.7547\/87507315-92-7-390"},{"key":"bibr5-2309499019836012","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpm.2007.10.008"},{"key":"bibr6-2309499019836012","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2007.0952"},{"key":"bibr7-2309499019836012","doi-asserted-by":"publisher","DOI":"10.1177\/1071100716671884"},{"key":"bibr8-2309499019836012","doi-asserted-by":"publisher","DOI":"10.1177\/107110070402500806"},{"key":"bibr9-2309499019836012","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2016.10.014"},{"key":"bibr10-2309499019836012","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2007.12.002"},{"key":"bibr11-2309499019836012","doi-asserted-by":"publisher","DOI":"10.1177\/107110079701801104"},{"key":"bibr12-2309499019836012","doi-asserted-by":"publisher","DOI":"10.7748\/ns2009.03.23.26.50.c6835"},{"key":"bibr13-2309499019836012","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"bibr14-2309499019836012","doi-asserted-by":"crossref","unstructured":"Moola S, Munn Z, Tufanaru C, Chapter 7: systematic reviews of etiology and risk. In: Aromataris E, Munn Z (Eds). Joanna Briggs Institute reviewer\u2019s manual. The Joanna Briggs Institute, Faculty of Health Sciences, University of Adelaide, https:\/\/reviewersmanual.joannabriggs.org\/Appendix\u00a07.1 (2017, accessed 12 June 2018).","DOI":"10.46658\/JBIRM-17-06"},{"key":"bibr15-2309499019836012","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2015.12.008"},{"key":"bibr16-2309499019836012","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5413.82343"},{"key":"bibr17-2309499019836012","doi-asserted-by":"publisher","DOI":"10.1177\/107110070502600709"},{"key":"bibr18-2309499019836012","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2005.10.003"},{"key":"bibr19-2309499019836012","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.91B10.22431"},{"key":"bibr20-2309499019836012","doi-asserted-by":"publisher","DOI":"10.1177\/1534734607302379"},{"key":"bibr21-2309499019836012","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-012-2470-9"},{"key":"bibr22-2309499019836012","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2004.11.004"}],"container-title":["Journal of Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2309499019836012","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2309499019836012","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2309499019836012","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:26:40Z","timestamp":1777595200000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2309499019836012"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,20]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,5,1]]}},"alternative-id":["10.1177\/2309499019836012"],"URL":"https:\/\/doi.org\/10.1177\/2309499019836012","relation":{},"ISSN":["1022-5536","2309-4990"],"issn-type":[{"value":"1022-5536","type":"print"},{"value":"2309-4990","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,20]]},"article-number":"2309499019836012"}}