{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T18:32:36Z","timestamp":1793298756168,"version":"4.5.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T00:00:00Z","timestamp":1619481600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T00:00:00Z","timestamp":1619481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Surg Res"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Nonunion is a rare complication for distal fibular fractures. However, when there is a high degree of comminution, nonunion may occur. In this article, we describe a novel technique that uses the oblong hole of a locking plate to lengthen the fibula for fracture reduction. This technique is straightforward and allows for easy control of the comminuted fracture to restore length and rotation at the time of plate application without opening the fracture site.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty-five consecutive patients, who were treated with the minimally invasive plate osteosynthesis (MIPO) technique for comminuted distal fibular fractures were retrospectively studied. The study included 19 men and 16 women, with a mean age of 47.0 years (range, 20 to 72). There were 3 lateral malleolar fractures with deltoid injury, 11 bimalleolar fractures, 7 trimalleolar fractures, and 14 distal tibiofibular fractures. The quality of fracture reduction was assessed by comparing the radiologic parameters (fibular length, talocrural angle, and medial clear space) between the affected ankle and the contralateral uninjured ankle.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two patients were not reachable and 5 declined to visit the clinic. For these 7 patients, the latest outcomes that were measured prospectively were used. Postoperative radiographs showed well-aligned ankle mortise, with fibular length restoration. The mean Olerud-Molander ankle score was 82.1 \u00b1 10.7 at a mean of 27.2 months (range, 12 to 58). There was one case of nonunion and one case of superficial peroneal nerve injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The MIPO technique, using the oblong hole of a locking plate, achieved satisfactory restoration of length and rotation, bone union, and clinical outcomes for the comminuted distal fibular fractures.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13018-021-02441-2","type":"journal-article","created":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T05:03:03Z","timestamp":1619499783000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Minimally invasive plate osteosynthesis using the oblong hole of a locking plate for comminuted distal fibular fractures"],"prefix":"10.1186","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3400-497X","authenticated-orcid":false,"given":"Young Uk","family":"Park","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4785-8154","authenticated-orcid":false,"given":"Sung Jae","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5934-0665","authenticated-orcid":false,"given":"Hyong Nyun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,27]]},"reference":[{"issue":"1","key":"2441_CR1","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1007\/s00264-013-2168-y","volume":"38","author":"MT Ovaska","year":"2014","unstructured":"Ovaska MT, M\u00e4kinen TJ, Madanat R, Kiljunen V, Lindahl J. A comprehensive analysis of patients with malreduced ankle fractures undergoing re-operation. Int Orthop. 2014;38(1):83\u20138. https:\/\/doi.org\/10.1007\/s00264-013-2168-y.","journal-title":"Int Orthop."},{"issue":"4","key":"2441_CR2","doi-asserted-by":"publisher","first-page":"490","DOI":"10.4055\/cios.2015.7.4.490","volume":"7","author":"SD Cha","year":"2015","unstructured":"Cha SD, Kwak JY, Gwak HC, Ha DJ, Kim JY, Kim UC, et al. Arthroscopic assessment of intra-articular lesion after surgery for rotational ankle fracture. Clin Orthop Surg. 2015;7(4):490\u20136. https:\/\/doi.org\/10.4055\/cios.2015.7.4.490.","journal-title":"Clin Orthop Surg."},{"issue":"6","key":"2441_CR3","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1177\/1071100715625292","volume":"37","author":"CC Chiang","year":"2016","unstructured":"Chiang CC, Tzeng YH, Lin CC, Huang CK, Chang MC. Minimally invasive versus open distal fibular plating for AO\/OTA 44-B ankle Ffactures. Foot Ankle Int. 2016;37(6):611\u20139. https:\/\/doi.org\/10.1177\/1071100715625292.","journal-title":"Foot Ankle Int."},{"issue":"5","key":"2441_CR4","doi-asserted-by":"publisher","first-page":"974","DOI":"10.2106\/00004623-200605000-00007","volume":"88","author":"KA Egol","year":"2006","unstructured":"Egol KA, Tejwani NC, Walsh MG, Capla EL, Koval KJ. Predictors of short-term functional outcome following ankle fracture surgery. J Bone Joint Surg Am. 2006;88(5):974\u20139. https:\/\/doi.org\/10.2106\/00004623-200605000-00007.","journal-title":"J Bone Joint Surg Am."},{"issue":"12","key":"2441_CR5","doi-asserted-by":"publisher","first-page":"2324","DOI":"10.1016\/j.injury.2019.10.001","volume":"50","author":"B El Fatayri","year":"2019","unstructured":"El Fatayri B, Bula\u00efd Y, Djebara AE, Havet E, Mertl P, Dehl M. A comparison of bone union and complication rates between locking and non-locking plates in distal fibular fracture: retrospective study of 106 cases. Injury. 2019;50(12):2324\u201331. https:\/\/doi.org\/10.1016\/j.injury.2019.10.001.","journal-title":"Injury."},{"issue":"3","key":"2441_CR6","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1053\/j.jfas.2013.08.002","volume":"54","author":"KY Kwaadu","year":"2015","unstructured":"Kwaadu KY, Fleming JJ, Lin D. Management of complex fibular fractures: double plating of fibular fractures. J Foot Ankle Surg. 2015;54(3):288\u201394. https:\/\/doi.org\/10.1053\/j.jfas.2013.08.002.","journal-title":"J Foot Ankle Surg."},{"issue":"2","key":"2441_CR7","doi-asserted-by":"publisher","first-page":"276","DOI":"10.2106\/00004623-200702000-00007","volume":"89","author":"J Siegel","year":"2007","unstructured":"Siegel J, Tornetta P 3rd. Extraperiosteal plating of pronation-abduction ankle fractures. J Bone Joint Surg Am. 2007;89(2):276\u201381. https:\/\/doi.org\/10.2106\/00004623-200702000-00007.","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"2441_CR8","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1177\/107110070402500302","volume":"25","author":"KH Chao","year":"2004","unstructured":"Chao KH, Wu CC, Lee CH, Chu CM, Wu SS. Corrective-elongation osteotomy without bone graft for old ankle fracture with residual diastasis. Foot Ankle Int. 2004;25(3):123\u20137. https:\/\/doi.org\/10.1177\/107110070402500302.","journal-title":"Foot Ankle Int."},{"issue":"4","key":"2441_CR9","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1302\/0301-620X.72B4.2116416","volume":"72","author":"RK Marti","year":"1990","unstructured":"Marti RK, Raaymakers EL, Norte PA. Malunited ankle fractures. The late results of reconstruction. J Bone Joint Surg Br. 1990;72(4):709\u201313.","journal-title":"J Bone Joint Surg Br."},{"key":"2441_CR10","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1097\/00003086-198211000-00026","volume":"171","author":"CM Offierski","year":"1982","unstructured":"Offierski CM, Graham JD, Hall JH, Harris WR, Schatzker JL. Late revision of fibular malunion in ankle fractures. Clin Orthop Relat Res. 1982;171:145\u20139.","journal-title":"Clin Orthop Relat Res."},{"issue":"7","key":"2441_CR11","doi-asserted-by":"publisher","first-page":"604","DOI":"10.3113\/FAI.2010.0604","volume":"31","author":"K Pelton","year":"2010","unstructured":"Pelton K, Thordarson DB, Barnwell J. Open versus closed treatment of the fibula in Maissoneuve injuries. Foot Ankle Int. 2010;31(7):604\u20138. https:\/\/doi.org\/10.3113\/FAI.2010.0604.","journal-title":"Foot Ankle Int."},{"issue":"8","key":"2441_CR12","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1302\/0301-620X.94B8.28620","volume":"94","author":"KE Bugler","year":"2012","unstructured":"Bugler KE, Watson CD, Hardie AR, Appleton P, McQueen MM, Court-Brown CM, et al. The treatment of unstable fractures of the ankle using the Acumed fibular nail: development of a technique. J Bone Joint Surg Br. 2012;94(8):1107\u201312. https:\/\/doi.org\/10.1302\/0301-620X.94B8.28620.","journal-title":"J Bone Joint Surg Br."},{"issue":"9","key":"2441_CR13","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1177\/1071100714537628","volume":"35","author":"EP Fitzpatrick","year":"2014","unstructured":"Fitzpatrick EP, Kwon JY. Use of a pointed reduction clamp placed on the distal fibula to ensure proper restoration of fibular length and rotation and anatomic reduction of the syndesmosis: a technique tip. Foot Ankle Int. 2014;35(9):943\u20138. https:\/\/doi.org\/10.1177\/1071100714537628.","journal-title":"Foot Ankle Int."},{"issue":"4","key":"2441_CR14","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1007\/s10195-014-0320-0","volume":"15","author":"S Jain","year":"2014","unstructured":"Jain S, Haughton BA, Brew C. Intramedullary fixation of distal fibular fractures: a systematic review of clinical and functional outcomes. J Orthop Traumatol. 2014;15(4):245\u201354. https:\/\/doi.org\/10.1007\/s10195-014-0320-0.","journal-title":"J Orthop Traumatol."},{"issue":"2","key":"2441_CR15","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1097\/BOT.0b013e3181d9e875","volume":"25","author":"F Hess","year":"2011","unstructured":"Hess F, Sommer C. Minimally invasive plate osteosynthesis of the distal fibula with the locking compression plate: first experience of 20 cases. J Orthop Trauma. 2011;25(2):110\u20135. https:\/\/doi.org\/10.1097\/BOT.0b013e3181d9e875.","journal-title":"J Orthop Trauma."},{"issue":"4","key":"2441_CR16","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1016\/j.ocl.2009.05.007","volume":"40","author":"M Ronga","year":"2009","unstructured":"Ronga M, Shanmugam C, Longo UG, Oliva F, Maffulli N. Minimally invasive osteosynthesis of distal tibial fractures using locking plates. Orthop Clin North Am. 2009;40(4):499\u2013504, ix. https:\/\/doi.org\/10.1016\/j.ocl.2009.05.007.","journal-title":"Orthop Clin North Am."},{"issue":"4","key":"2441_CR17","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1007\/s11999-009-0991-7","volume":"468","author":"M Ronga","year":"2010","unstructured":"Ronga M, Longo UG, Maffulli N. Minimally invasive locked plating of distal tibia fractures is safe and effective. Clin Orthop Relat Res. 2010;468(4):975\u201382. https:\/\/doi.org\/10.1007\/s11999-009-0991-7.","journal-title":"Clin Orthop Relat Res."},{"issue":"3","key":"2441_CR18","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1053\/j.jfas.2004.03.005","volume":"43","author":"AD Toms","year":"2004","unstructured":"Toms AD, McMurtie A, Maffulli N. Percutaneous plating of the distal tibia. J Foot Ankle Surg. 2004;43(3):199\u2013203. https:\/\/doi.org\/10.1053\/j.jfas.2004.03.005.","journal-title":"J Foot Ankle Surg."},{"issue":"5","key":"2441_CR19","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1001\/archsurg.1950.01250010980011","volume":"60","author":"N Lauge-Hansen","year":"1950","unstructured":"Lauge-Hansen N. Fractures of the ankle. II. Combined experimental-surgical and experimental-roentgenologic investigations. Arch Surg. 1950;60(5):957\u201385. https:\/\/doi.org\/10.1001\/archsurg.1950.01250010980011.","journal-title":"Arch Surg."},{"issue":"2","key":"2441_CR20","doi-asserted-by":"publisher","first-page":"157","DOI":"10.3113\/FAI-2009-0157","volume":"30","author":"HJ Lee","year":"2009","unstructured":"Lee HJ, Kang KS, Kang SY, Lee JS. Percutaneous reduction technique using a Kirschner wire for displaced posterior malleolar fractures. Foot Ankle Int. 2009;30(2):157\u20139. https:\/\/doi.org\/10.3113\/FAI-2009-0157.","journal-title":"Foot Ankle Int."},{"issue":"11","key":"2441_CR21","doi-asserted-by":"publisher","first-page":"956","DOI":"10.3113\/FAI.2012.0956","volume":"33","author":"JM Murphy","year":"2012","unstructured":"Murphy JM, Kadakia AR, Irwin TA. Variability in radiographic medial clear space measurement of the normal weight-bearing ankle. Foot Ankle Int. 2012;33(11):956\u201363. https:\/\/doi.org\/10.3113\/FAI.2012.0956.","journal-title":"Foot Ankle Int."},{"issue":"2","key":"2441_CR22","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1177\/107110078901000210","volume":"10","author":"B Rolfe","year":"1989","unstructured":"Rolfe B, Nordt W, Sallis JG, Distefano M. Assessing fibular length using bimalleolar angular measurements. Foot Ankle. 1989;10(2):104\u20139. https:\/\/doi.org\/10.1177\/107110078901000210.","journal-title":"Foot Ankle."},{"issue":"3","key":"2441_CR23","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1007\/BF00435553","volume":"103","author":"C Olerud","year":"1984","unstructured":"Olerud C, Molander H. A scoring for symptom evaluation after ankle fracture. Arch Orthop Trauma Surg. 1984;103(3):190\u20134. https:\/\/doi.org\/10.1007\/BF00435553.","journal-title":"Arch Orthop Trauma Surg."},{"issue":"10","key":"2441_CR24","doi-asserted-by":"publisher","first-page":"1409","DOI":"10.1007\/s00402-011-1318-1","volume":"131","author":"T Neubauer","year":"2011","unstructured":"Neubauer T, Heidari N, Weinberg AM, Grechenig W, Tesch NP, Pichler W, et al. The risk of nerve injury with minimally invasive plate osteosynthesis of distal fibula fractures: an anatomic study. Arch Orthop Trauma Surg. 2011;131(10):1409\u201312. https:\/\/doi.org\/10.1007\/s00402-011-1318-1.","journal-title":"Arch Orthop Trauma Surg."},{"issue":"3","key":"2441_CR25","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1177\/1938640018790082","volume":"12","author":"NA Ebraheim","year":"2019","unstructured":"Ebraheim NA, Vander Maten JW, Delaney JR, White E, Hanna M, Liu J. Cannulated intramedullary screw fixation of distal fibular fractures. Foot Ankle Spec. 2019;12(3):264\u201371. https:\/\/doi.org\/10.1177\/1938640018790082.","journal-title":"Foot Ankle Spec."},{"issue":"9","key":"2441_CR26","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1016\/j.injury.2006.06.002","volume":"37","author":"S Hazarika","year":"2006","unstructured":"Hazarika S, Chakravarthy J, Cooper J. Minimally invasive locking plate osteosynthesis for fractures of the distal tibia--results in 20 patients. Injury. 2006;37(9):877\u201387. https:\/\/doi.org\/10.1016\/j.injury.2006.06.002.","journal-title":"Injury."},{"issue":"3","key":"2441_CR27","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1007\/s12306-013-0292-x","volume":"97","author":"C Iacobellis","year":"2013","unstructured":"Iacobellis C, Chemello C, Zornetta A, Aldegheri R. Minimally invasive plate osteosynthesis in type B fibular fractures versus open surgery. Musculoskelet Surg. 2013;97(3):229\u201335. https:\/\/doi.org\/10.1007\/s12306-013-0292-x.","journal-title":"Musculoskelet Surg."},{"issue":"2","key":"2441_CR28","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1097\/TA.0b013e31818936ff","volume":"66","author":"DE Krenk","year":"2009","unstructured":"Krenk DE, Molinero KG, Mascarenhas L, Muffly MT, Altman GT. Results of minimally invasive distal fibular plate osteosynthesis. J Trauma. 2009;66(2):570\u20135. https:\/\/doi.org\/10.1097\/TA.0b013e31818936ff.","journal-title":"J Trauma."},{"issue":"4","key":"2441_CR29","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1007\/s00264-006-0216-6","volume":"31","author":"PB McKenna","year":"2007","unstructured":"McKenna PB, O'shea K, Burke T. Less is more: lag screw only fixation of lateral malleolar fractures. Int Orthop. 2007;31(4):497\u2013502. https:\/\/doi.org\/10.1007\/s00264-006-0216-6.","journal-title":"Int Orthop."},{"issue":"9","key":"2441_CR30","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.1302\/0301-620X.98B9.35837","volume":"98","author":"TO White","year":"2016","unstructured":"White TO, Bugler KE, Appleton P, Will E, McQueen MM, Court-Brown CM. A prospective randomised controlled trial of the fibular nail versus standard open reduction and internal fixation for fixation of ankle fractures in elderly patients. Bone Joint J. 2016;98(9):1248\u201352. https:\/\/doi.org\/10.1302\/0301-620X.98B9.35837.","journal-title":"Bone Joint J."},{"issue":"1","key":"2441_CR31","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.fas.2017.08.008","volume":"25","author":"O Coifman","year":"2019","unstructured":"Coifman O, Bariteau JT, Shazar N, Tenenbaum SA. Lateral malleolus closed reduction and internal fixation with intramedullary fibular rod using minimal invasive approach for the treatment of ankle fractures. Foot Ankle Surg. 2019;25(1):79\u201383. https:\/\/doi.org\/10.1016\/j.fas.2017.08.008.","journal-title":"Foot Ankle Surg."},{"issue":"Suppl 1","key":"2441_CR32","doi-asserted-by":"publisher","first-page":"S8","DOI":"10.1016\/S0020-1383(18)30295-X","volume":"49","author":"DJ Hak","year":"2018","unstructured":"Hak DJ, Banegas R, Ipaktchi K, Mauffrey C. Evolution of plate design and material composition. Injury. 2018;49(Suppl 1):S8\u2013S11. https:\/\/doi.org\/10.1016\/S0020-1383(18)30295-X.","journal-title":"Injury."},{"issue":"4","key":"2441_CR33","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1302\/0301-620X.72B4.2116417","volume":"72","author":"AJ Ward","year":"1990","unstructured":"Ward AJ, Ackroyd CE, Baker AS. Late lengthening of the fibula for malaligned ankle fractures. J Bone Joint Surg Br. 1990;72(4):714\u20137.","journal-title":"J Bone Joint Surg Br."},{"issue":"4","key":"2441_CR34","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1007\/BF00266071","volume":"4","author":"BG Weber","year":"1981","unstructured":"Weber BG. Lengthening osteotomy of the fibula to correct a widened mortice of the ankle after fracture. Int Orthop. 1981;4(4):289\u201393. https:\/\/doi.org\/10.1007\/BF00266071.","journal-title":"Int Orthop."},{"issue":"9","key":"2441_CR35","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1177\/1071100715584847","volume":"36","author":"B Huang","year":"2015","unstructured":"Huang B, Dong Q, Hong DY, Park YW, Kim HN. Fibular lengthening using the elongated combi-hole of a locking compression plate: Technical Tip. Foot Ankle Int. 2015;36(9):1104\u20139. https:\/\/doi.org\/10.1177\/1071100715584847.","journal-title":"Foot Ankle Int."}],"container-title":["Journal of Orthopaedic Surgery and Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-021-02441-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13018-021-02441-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-021-02441-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,25]],"date-time":"2022-12-25T14:18:24Z","timestamp":1671977904000},"score":1,"resource":{"primary":{"URL":"https:\/\/josr-online.biomedcentral.com\/articles\/10.1186\/s13018-021-02441-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,27]]},"references-count":35,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2441"],"URL":"https:\/\/doi.org\/10.1186\/s13018-021-02441-2","relation":{},"ISSN":["1749-799X"],"issn-type":[{"value":"1749-799X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,27]]},"assertion":[{"value":"22 February 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 April 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by Hallym University Kangnam Sacred Heart Hospital Institutional Review Board (IRB number: 2015-01-15). Informed consent was received from all the patients of this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declared that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"281"}}