{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:22:50Z","timestamp":1777612970435,"version":"3.51.4"},"reference-count":38,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"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 &amp; Ankle Orthopaedics"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Pilon fractures of the distal tibial plafond account for 1% to 10% of all tibial fractures and are often associated with serious complications. As body mass index (BMI) is known to impact post-operative outcomes, particularly infection and nonunion, after trauma, the goal of this study is to explore these trends after pilon fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A single-center retrospective review of patients undergoing surgical fixation for pilon fractures between January 2013 and June 2023 was conducted. Only patients with at least a 6-month follow-up period were included. Demographic data and injury characteristics were extracted. Post-operative outcomes and complications were computed. Bivariate analysis via\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      test were applied, followed by multivariate analysis using primary and reduced models to evaluate for poor outcomes. Various BMI cutoffs (\u226530, \u226535, \u226540, \u226545) were also employed to evaluate the relationship between outcomes and various obesity categories. Nonunion was assessed at \u22656\u2009months postoperatively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There were 132 patients included. There was no significant relationship between BMI and infection rates, nonunion rates, and development of post-traumatic osteoarthritis (PTOA) on bivariate analysis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&gt;\u2009.05). On multivariate analysis, diabetes mellitus was a risk factor for infection (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.01), but BMI was not predictive of any outcomes in the primary or reduced models (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&gt;\u2009.05). There were no significant differences in infection, nonunion, and PTOA rates when employing various BMI cutoffs (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&gt;\u2009.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>BMI was not found to be an independent predictor of post-operative complications in patients with pilon fractures in this cohort. Our study suggests that pilon fractures are unique and counter historic lower-extremity injury postoperative care protocols that consider weight, although further investigation in larger cohorts with long-term follow-up is required to define this trend.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III, retrospective cohort series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/24730114251398761","type":"journal-article","created":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T05:58:10Z","timestamp":1766210290000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Body Mass Index and Outcomes After Pilon Fracture Fixation: A Retrospective Cohort 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