{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T03:37:54Z","timestamp":1793763474828,"version":"4.6.1"},"reference-count":70,"publisher":"Bioscientifica","issue":"9","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["eor.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Fragility ankle fractures are traditionally managed conservatively or with open reduction internal fixation. Tibiotalocalcaneal (TTC) nailing is an alternative option for the geriatric patient. This meta-analysis provides the most detailed analysis of TTC nailing for fragility ankle fractures.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>A systematic search was performed on MEDLINE, EMBASE, Cochrane Library, and Web of Science, identifying 14 studies for inclusion. Studies including patients with a fragility ankle fracture, defined according to NICE guidelines as a low-energy fracture obtained following a fall from standing height or less, that were treated with TTC nail were included. Patients with a previous fracture of the ipsilateral limb, fibular nails, and pathological fractures were excluded. This review was registered in PROSPERO (ID: CRD42021258893).<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>\n                          A total of 312 ankle fractures were included. The mean age was 77.3 years old. In this study, 26.9% were male, and 41.9% were diabetics. The pooled proportion of superficial infection was 10% (95% CI: 0.06\u20130.16), deep infection 8% (95% CI: 0.06\u20130.11), implant failure 11% (95% CI: 0.07\u20130.15), malunion 11% (95% CI: 0.06\u20130.18), and all-cause mortality 27% (95% CI: 0.20\u20130.34). The pooled mean post-operative Olerud\u2013Molander ankle score was 54.07 (95% CI: 48.98\u201359.16). Egger\u2019s test (\n                          <jats:italic>P<\/jats:italic>\n                          \u2009=\u20090.56) showed no significant publication bias.\n                        <\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>TTC nailing is an adequate alternative option for fragility ankle fractures. However, current evidence includes mainly case series with inconsistent post-operative rehabilitation protocols. Prospective randomised control trials with long follow-up times and large cohort sizes are needed to guide the use of TTC nailing for ankle fractures.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/eor-22-0017","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T05:08:58Z","timestamp":1663650538000},"page":"628-643","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":25,"title":["Retrograde tibiotalocalcaneal nailing for the treatment of acute ankle fractures in the elderly: a systematic review and meta-analysis"],"prefix":"10.1530","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6818-1683","authenticated-orcid":true,"given":"Victor","family":"Lu","sequence":"first","affiliation":[{"name":"School of Clinical Medicine, University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Tennyson","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Addenbrooke\u2019s Hospital, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Zhou","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Shrewsbury and Telford Hospital NHS Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary D","family":"Fortune","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azeem","family":"Thahir","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Addenbrooke\u2019s Hospital, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matija","family":"Krkovic","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Addenbrooke\u2019s Hospital, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Journal of the Foot and Ankle","first-page":"117","article-title":"Acute retrograde tibiotalocalcaneal nailing in osteoporotic periarticular ankle fractures","volume":"14","author":"Herrera-P\u00e9rez","year":"2020","unstructured":"Herrera-P\u00e9rez MMart\u00edn-V\u00e9lez PRend\u00f3n-D\u00edaz DLuis Pais-Brito JLHerrera-Perez M. 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