{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T18:31:57Z","timestamp":1793298717729,"version":"4.5.0"},"reference-count":60,"publisher":"Bioscientifica","issue":"5","license":[{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"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":[[2023,5,1]]},"abstract":"<jats:p>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>The relevance of geriatric ankle fractures is continuously increasing.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Treatment of these patients remains challenging and requires adapted diagnostic and therapeutic strategies, as compliance to partial weight bearing is difficult to maintain compared to younger patients.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>In addition, in the elderly even low impact injuries may lead to severe soft tissue trauma, influencing timing and operative strategies.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Recently, the direct posterolateral approach and plate fixation techniques, angular stable implants as well as intramedullary nailing of the distal fibula have been found to improve stategical concepts.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>This article aims to provide a comprehensive overview of the diagnostic and recent aspects with respect to how this difficult entity of injuries should be approached.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:p>","DOI":"10.1530\/eor-23-0052","type":"journal-article","created":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T08:54:46Z","timestamp":1683622486000},"page":"223-230","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":23,"title":["Ankle fractures in the elderly: Do we have new concepts?"],"prefix":"10.1530","volume":"8","author":[{"given":"Michael J","family":"Raschke","sequence":"first","affiliation":[{"name":"Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Ochman","sequence":"additional","affiliation":[{"name":"Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Milstrey","sequence":"additional","affiliation":[{"name":"Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Archives of Orthopaedic and Trauma Surgery","first-page":"3771","article-title":"Trends of incidence and treatment strategies for operatively treated distal fibula fractures from 2005 to 2019: a nationwide register analysis","volume":"142","author":"Milstrey","year":"2022","unstructured":"Milstrey ABaumbach SFPfleiderer AEvers JBoecker WRaschke MJPolzer H & Ochman S. Trends of incidence and treatment strategies for operatively treated distal fibula fractures from 2005 to 2019: a nationwide register analysis. Archives of Orthopaedic and Trauma Surgery20221423771\u20133777. (https:\/\/doi.org\/10.1007\/s00402-021-04232-0)"},{"key":"bib2","series-title":"Acta Orthopaedica Scandinavica","first-page":"539","article-title":"Llstrup DM. Epidemiology of ankle fractures in Rochester, Minnesota","volume":"58","author":"Daly","year":"2009","unstructured":"Daly PJFitzgerald RH & Melton LJ. Llstrup DM. Epidemiology of ankle fractures in Rochester, Minnesota. Acta Orthopaedica Scandinavica200958539\u2013544. (https:\/\/doi.org\/10.3109\/17453678709146395)"},{"key":"bib3","series-title":"Bone","first-page":"238","article-title":"Lifestyle and other factors predict ankle fractures in perimenopausal women: a population-based prospective cohort study","volume":"30","author":"Valtola","year":"2002","unstructured":"Valtola AHonkanen RKr\u00f6ger HTuppurainen MSaarikoski S & Alhava E. Lifestyle and other factors predict ankle fractures in perimenopausal women: a population-based prospective cohort study. Bone200230238\u2013242. (https:\/\/doi.org\/10.1016\/s8756-3282(0100649-4)"},{"key":"bib4","series-title":"Acta Orthopaedica Scandinavica","first-page":"508","article-title":"How well can a previous fracture indicate a new fracture? A questionnaire study of 29, 802 postmenopausal women","volume":"69","author":"Gunnes","year":"1998","unstructured":"Gunnes MMellstr\u00f6m D & Johnell O. How well can a previous fracture indicate a new fracture? A questionnaire study of 29, 802 postmenopausal women. Acta Orthopaedica Scandinavica199869508\u2013512. (https:\/\/doi.org\/10.3109\/17453679808997788)"},{"key":"bib5","series-title":"Journal of Foot and Ankle Surgery","first-page":"1049","article-title":"Association between bone mineral density and elderly ankle fractures: a systematic review and meta-analysis","volume":"59","author":"So","year":"2020","unstructured":"So ERushing CJSimon JEGoss DAPrissel MA & Berlet GC. Association between bone mineral density and elderly ankle fractures: a systematic review and meta-analysis. Journal of Foot and Ankle Surgery2020591049\u20131057. (https:\/\/doi.org\/10.1053\/j.jfas.2020.03.012)"},{"key":"bib6","series-title":"Osteoporosis International","first-page":"2147","article-title":"Prior ankle fractures in postmenopausal women are associated with low areal bone mineral density and bone microstructure alterations","volume":"26","author":"Biver","year":"2015","unstructured":"Biver EDurosier CChevalley THerrmann FRFerrari S & Rizzoli R. Prior ankle fractures in postmenopausal women are associated with low areal bone mineral density and bone microstructure alterations. Osteoporosis International2015262147\u20132155. (https:\/\/doi.org\/10.1007\/s00198-015-3119-9)"},{"key":"bib7","series-title":"Unfallchirurg","first-page":"200","article-title":"Sprunggelenkfraktur beim \u00e4lteren Patienten","volume":"124","author":"Ochman","year":"2021","unstructured":"Ochman S & Raschke MJ. Sprunggelenkfraktur beim \u00e4lteren Patienten. Unfallchirurg2021124200\u2013211. (https:\/\/doi.org\/10.1007\/s00113-021-00953-4)"},{"key":"bib8","series-title":"Osteoporosis International","first-page":"2819","article-title":"Ankle fractures have features of an osteoporotic fracture","volume":"24","author":"Lee","year":"2013","unstructured":"Lee KMChung CYKwon SSWon SHLee SYChung MK & Park MS. Ankle fractures have features of an osteoporotic fracture. Osteoporosis International2013242819\u20132825. (https:\/\/doi.org\/10.1007\/s00198-013-2394-6)"},{"key":"bib9","series-title":"Unfallchirurg","article-title":"Ankle fractures in the elderly","volume":"114","author":"Pichl","year":"2011","unstructured":"Pichl J & Hoffmann R. Ankle fractures in the elderly. Unfallchirurg2011114 681\u2013687. (https:\/\/doi.org\/10.1007\/s00113-011-2023-9)"},{"key":"bib10","series-title":"Orthop\u00e4de","first-page":"332","article-title":"Frakturversorgung des oberen Sprunggelenks im hohen Lebensalter","volume":"43","author":"Zwipp","year":"2014","unstructured":"Zwipp H & Amlang M. Frakturversorgung des oberen Sprunggelenks im hohen Lebensalter. Orthop\u00e4de201443332\u2013338. (https:\/\/doi.org\/10.1007\/s00132-013-2168-z)"},{"key":"bib11","series-title":"Zeitschrift f\u00fcr Orthop\u00e4die und Unfallchirurgie","first-page":"45","article-title":"Einschr\u00e4nkungen der Aussagekraft des konventionellen R\u00f6ntgenbilds bei Sprunggelenksfrakturen im Alter","volume":"155","author":"Jubel","year":"2016","unstructured":"Jubel AFaymonville CAndermahr JBoxberg S & Schiffer G. Einschr\u00e4nkungen der Aussagekraft des konventionellen R\u00f6ntgenbilds bei Sprunggelenksfrakturen im Alter. Zeitschrift f\u00fcr Orthop\u00e4die und Unfallchirurgie201615545\u201351. (https:\/\/doi.org\/10.1055\/s-0042-113879)"},{"key":"bib12","series-title":"International Orthopaedics","first-page":"395","article-title":"Standardised pre-operative diagnostics and treatment of peripheral arterial disease reduce wound complications in geriatric ankle fractures","volume":"42","author":"Aigner","year":"2018","unstructured":"Aigner RLechler PBoese CKBockmann BRuchholtz S & Frink M. Standardised pre-operative diagnostics and treatment of peripheral arterial disease reduce wound complications in geriatric ankle fractures. International Orthopaedics201842395\u2013400. (https:\/\/doi.org\/10.1007\/s00264-017-3705-x)"},{"key":"bib13","series-title":"Injury","first-page":"116","article-title":"Ankle fractures in the elderly: MUA versus ORIF","volume":"24","author":"Anand","year":"1993","unstructured":"Anand N & Klenerman L. Ankle fractures in the elderly: MUA versus ORIF. Injury199324116\u2013120. (https:\/\/doi.org\/10.1016\/0020-1383(9390202-h)"},{"key":"bib14","series-title":"Foot and Ankle International","first-page":"399","article-title":"Results of operative fixation of unstable ankle fractures in geriatric patients","volume":"22","author":"Pagliaro","year":"2001","unstructured":"Pagliaro AJMichelson JD & Mizel MS. Results of operative fixation of unstable ankle fractures in geriatric patients. Foot and Ankle International200122399\u2013402. (https:\/\/doi.org\/10.1177\/107110070102200507)"},{"key":"bib15","series-title":"Injury","first-page":"780","article-title":"Early complications of surgery in operative treatment of ankle fractures in those over 60: a review of 186 cases","volume":"45","author":"Zaghloul","year":"2014","unstructured":"Zaghloul AHaddad BBarksfield R & Davis B. Early complications of surgery in operative treatment of ankle fractures in those over 60: a review of 186 cases. Injury201445780\u2013783. (https:\/\/doi.org\/10.1016\/j.injury.2013.11.008)"},{"key":"bib16","series-title":"Foot and Ankle Surgery","first-page":"103","article-title":"Complications after open reduction and internal fixation of ankle fractures in the elderly","volume":"18","author":"Lynde","year":"2012","unstructured":"Lynde MJSautter THamilton GA & Schuberth JM. Complications after open reduction and internal fixation of ankle fractures in the elderly. Foot and Ankle Surgery201218103\u2013107. (https:\/\/doi.org\/10.1016\/j.fas.2011.03.010)"},{"key":"bib17","series-title":"Injury","first-page":"559","article-title":"Internal fixation of ankle fractures in the very elderly","volume":"32","author":"Srinivasan","year":"2001","unstructured":"Srinivasan CMS & Moran CG. Internal fixation of ankle fractures in the very elderly. Injury200132559\u2013563. (https:\/\/doi.org\/10.1016\/s0020-1383(0100034-1)"},{"key":"bib18","series-title":"Foot and Ankle International","first-page":"599","article-title":"Operative fixation of unstable ankle fractures in patients aged over 80 years","volume":"32","author":"Shivarathre","year":"2011","unstructured":"Shivarathre DGChandran P & Platt SR. Operative fixation of unstable ankle fractures in patients aged over 80 years. Foot and Ankle International201132599\u2013602. (https:\/\/doi.org\/10.3113\/FAI.2011.0599)"},{"key":"bib19","series-title":"Foot and Ankle International","first-page":"102","article-title":"Operative treatment of ankle fractures: A minimum ten-year follow-up","volume":"22","author":"Day","year":"2001","unstructured":"Day GASwanson CE & Hulcombe BG. Operative treatment of ankle fractures: A minimum ten-year follow-up. Foot and Ankle International200122102\u2013106. (https:\/\/doi.org\/10.1177\/107110070102200204)"},{"key":"bib20","series-title":"Journal of Bone and Joint Surgery. American Volume","first-page":"1042","article-title":"Complication rates following open reduction and internal fixation of ankle fractures","volume":"91","author":"SooHoo","year":"2009","unstructured":"SooHoo NFKrenek LEagan MJGurbani BKo CY & Zingmond DS. Complication rates following open reduction and internal fixation of ankle fractures. Journal of Bone and Joint Surgery. American Volume2009911042\u20131049. (https:\/\/doi.org\/10.2106\/JBJS.H.00653)"},{"key":"bib21","series-title":"Foot and Ankle Surgery","first-page":"409","article-title":"Surgical versus conservative treatment for ankle fractures in adults: a systematic review and meta-analysis of the benefits and harms","volume":"25","author":"Larsen","year":"2019","unstructured":"Larsen PRathleff MS & Elsoe R. Surgical versus conservative treatment for ankle fractures in adults: a systematic review and meta-analysis of the benefits and harms. Foot and Ankle Surgery201925409\u2013417. (https:\/\/doi.org\/10.1016\/j.fas.2018.02.009)"},{"key":"bib22","series-title":"JAMA","first-page":"1455","article-title":"Close contact casting vs surgery for initial treatment of unstable ankle fractures in older adults: a randomized clinical trial","volume":"316","author":"Willett","year":"2016","unstructured":"Willett KKeene DJMistry DNam JTutton EHandley RMorgan LRoberts EBriggs ALall R, Close contact casting vs surgery for initial treatment of unstable ankle fractures in older adults: a randomized clinical trial. JAMA20163161455\u20131463. (https:\/\/doi.org\/10.1001\/jama.2016.14719)"},{"key":"bib23","series-title":"Unfallchirurg","first-page":"979","article-title":"Frakturen des oberen Sprunggelenks beim \u00e4lteren Patienten","volume":"120","author":"Klos","year":"2017","unstructured":"Klos KSimons PM\u00fcckley TKarich BRandt T & Knobe M. Frakturen des oberen Sprunggelenks beim \u00e4lteren Patienten. Unfallchirurg2017120979\u2013992. (https:\/\/doi.org\/10.1007\/s00113-017-0423-1)"},{"key":"bib24","series-title":"Archives of Orthopaedic and Trauma Surgery","first-page":"505","article-title":"Anatomy and classification of the posterior tibial fragment in ankle fractures","volume":"135","author":"Barton\u00ed\u010dek","year":"2015","unstructured":"Barton\u00ed\u010dek JRammelt SKostliv\u00fd KVan\u011b\u010dek VKlika D & Tre\u0161l I. Anatomy and classification of the posterior tibial fragment in ankle fractures. Archives of Orthopaedic and Trauma Surgery2015135505\u2013516. (https:\/\/doi.org\/10.1007\/s00402-015-2171-4)"},{"key":"bib25","series-title":"Foot and Ankle Clinics","first-page":"125","article-title":"Posterior malleolar fractures changing concepts and recent developments","volume":"22","author":"Barton\u00ed\u010dek","year":"2017","unstructured":"Barton\u00ed\u010dek JRammelt S & Tu\u010dek M. Posterior malleolar fractures changing concepts and recent developments. Foot and Ankle Clinics201722125\u2013145. (https:\/\/doi.org\/10.1016\/j.fcl.2016.09.009)"},{"key":"bib26","series-title":"Bone and Joint Journal","first-page":"1229","article-title":"Posterior malleolar ankle fractures","volume":"102\u2013B","author":"Blom","year":"2020","unstructured":"Blom RPHayat BAl-Dirini RMASierevelt IKerkhoffs GMMJGoslings JCJaarsma RLDoornberg JN & EF3X-trial Study Group. Posterior malleolar ankle fractures. Bone and Joint Journal2020102\u2013B1229\u20131241. (https:\/\/doi.org\/10.1302\/0301-620X.102B9.BJJ-2019-1660.R1)"},{"key":"bib27","series-title":"Foot and Ankle International","first-page":"58","article-title":"Biomechanical analysis of stability of posterior antiglide plating in osteoporotic pronation abduction ankle fracture model with posterior tibial fragment","volume":"38","author":"Hartwich","year":"2017","unstructured":"Hartwich KGomez ALPyrc JGut RRammelt S & Grass R. Biomechanical analysis of stability of posterior antiglide plating in osteoporotic pronation abduction ankle fracture model with posterior tibial fragment. Foot and Ankle International20173858\u201365. (https:\/\/doi.org\/10.1177\/1071100716669359)"},{"key":"bib28","series-title":"Journal of Foot and Ankle Surgery","first-page":"559","article-title":"Single oblique posterolateral approach for open reduction and internal fixation of posterior malleolar fractures with an associated lateral malleolar fracture","volume":"54","author":"Choi","year":"2015","unstructured":"Choi JYKim JHKo HT & Suh JS. Single oblique posterolateral approach for open reduction and internal fixation of posterior malleolar fractures with an associated lateral malleolar fracture. Journal of Foot and Ankle Surgery201554559\u2013564. (https:\/\/doi.org\/10.1053\/j.jfas.2014.09.043)"},{"key":"bib29","series-title":"Journal of Foot and Ankle Surgery","first-page":"607","article-title":"Posterolateral approach for treatment of posterior malleolus fracture of the ankle","volume":"50","author":"Abdelgawad","year":"2011","unstructured":"Abdelgawad AAKadous A & Kanlic E. Posterolateral approach for treatment of posterior malleolus fracture of the ankle. Journal of Foot and Ankle Surgery201150607\u2013611. (https:\/\/doi.org\/10.1053\/j.jfas.2011.04.022)"},{"key":"bib30","series-title":"Injury","first-page":"564","article-title":"Open reduction and internal fixation of the posterior malleolus fragment frequently restores syndesmotic stability","volume":"50","author":"Baumbach","year":"2019","unstructured":"Baumbach SFHerterich VDamblemont AHieber FB\u00f6cker W & Polzer H. Open reduction and internal fixation of the posterior malleolus fragment frequently restores syndesmotic stability. Injury201950564\u2013570. (https:\/\/doi.org\/10.1016\/j.injury.2018.12.025)"},{"key":"bib31","series-title":"Journal of Orthopaedic Trauma","first-page":"562","article-title":"Comparison of lateral locking plate and antiglide plate for fixation of distal fibular fractures in osteoporotic bone&colon: a biomechanical study","volume":"20","author":"Minihane","year":"2006","unstructured":"Minihane KPLee CAhn CZhang LQ & Merk BR. Comparison of lateral locking plate and antiglide plate for fixation of distal fibular fractures in osteoporotic bone&colon: a biomechanical study. Journal of Orthopaedic Trauma200620562\u2013566. (https:\/\/doi.org\/10.1097\/01.bot.0000245684.96775.82)"},{"key":"bib32","series-title":"Journal of Orthopaedic Surgery and Research","article-title":"Treating AO\/OTA 44B lateral malleolar fracture in patients over 50 years of age: periarticular locking plate versus non-locking plate","volume":"15","author":"Shih","year":"2020","unstructured":"Shih CAJou IMLee PYLu CLSu WRYeh ML & Wu PT. Treating AO\/OTA 44B lateral malleolar fracture in patients over 50 years of age: periarticular locking plate versus non-locking plate. Journal of Orthopaedic Surgery and Research202015 112. (https:\/\/doi.org\/10.1186\/s13018-020-01622-9)"},{"key":"bib33","series-title":"Injury","first-page":"718","article-title":"A contoured locking plate for distal fibular fractures in osteoporotic bone: a biomechanical cadaver study","volume":"43","author":"Zahn","year":"2012","unstructured":"Zahn RKFrey SJakubietz RGJakubietz MGDoht SSchneider PWaschke J & Meffert RH. A contoured locking plate for distal fibular fractures in osteoporotic bone: a biomechanical cadaver study. Injury201243718\u2013725. (https:\/\/doi.org\/10.1016\/j.injury.2011.07.009)"},{"key":"bib34","series-title":"Journal of Orthopaedic Surgery and Research","article-title":"A biomechanical comparison study of a modern fibular nail and distal fibular locking plate in AO\/OTA 44C2 ankle fractures","volume":"11","author":"Switaj","year":"2016","unstructured":"Switaj PJFuchs DAlshouli MPatwardhan AGVoronov LIMuriuki MHavey RM & Kadakia AR. A biomechanical comparison study of a modern fibular nail and distal fibular locking plate in AO\/OTA 44C2 ankle fractures. Journal of Orthopaedic Surgery and Research201611 100. (https:\/\/doi.org\/10.1186\/s13018-016-0435-5)"},{"key":"bib35","series-title":"Clinical Biomechanics","first-page":"14","article-title":"Reinforced fixation of distal fibula fractures in elderly patients: a meta-analysis of biomechanical studies","volume":"36","author":"Dingemans","year":"2016","unstructured":"Dingemans SALodeizen OAPGoslings JC & Schepers T. Reinforced fixation of distal fibula fractures in elderly patients: a meta-analysis of biomechanical studies. Clinical Biomechanics20163614\u201320. (https:\/\/doi.org\/10.1016\/j.clinbiomech.2016.05.006)"},{"key":"bib36","series-title":"Orthopaedics and Traumatology, Surgery and Research","first-page":"645","article-title":"Does a polyaxial-locking system confer benefits for osteosynthesis of the distal fibula: a cadaver study","volume":"102","author":"Hallbauer","year":"2016","unstructured":"Hallbauer JKlos KGr\u00e4fenstein ASimons PRausch SM\u00fcckley T & Hofmann GO. Does a polyaxial-locking system confer benefits for osteosynthesis of the distal fibula: a cadaver study. Orthopaedics and Traumatology, Surgery and Research2016102645\u2013649. (https:\/\/doi.org\/10.1016\/j.otsr.2016.03.014)"},{"key":"bib37","series-title":"Bone and Joint Journal","first-page":"1248","article-title":"A prospective randomised controlled trial of the fibular nail versus standard open reduction and internal fixation for fixation of ankle fractures in elderly patients","volume":"98-B","author":"White","year":"2016","unstructured":"White TOBugler KEAppleton PWill EMcQueen 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 and Joint Journal201698-B1248\u20131252. ( )"},{"key":"bib38","series-title":"Orthopaedics and Traumatology, Surgery and Research","first-page":"S255","article-title":"Internal fixation of the fibula in ankle fractures. A prospective, randomized and comparative study: plating versus nailing","volume":"100","author":"Asloum","year":"2014","unstructured":"Asloum YBedin BRoger TCharissoux JLArnaud JP & Mabit C. Internal fixation of the fibula in ankle fractures. A prospective, randomized and comparative study: plating versus nailing. Orthopaedics and Traumatology, Surgery and Research2014100S255\u2013S259. (https:\/\/doi.org\/10.1016\/j.otsr.2014.03.005)"},{"key":"bib39","series-title":"Journal of Orthopaedic Trauma","first-page":"e401","article-title":"The fibular intramedullary nail versus locking plate and lag screw fixation in the management of unstable elderly ankle fractures: a cadaveric biomechanical comparison","volume":"34","author":"Carter","year":"2020","unstructured":"Carter THWallace RMackenzie SAOliver WMDuckworth AD & White TO. The fibular intramedullary nail versus locking plate and lag screw fixation in the management of unstable elderly ankle fractures: a cadaveric biomechanical comparison. Journal of Orthopaedic Trauma202034e401\u2013e406. (https:\/\/doi.org\/10.1097\/BOT.0000000000001814)"},{"key":"bib40","series-title":"Cureus","article-title":"Osteoporotic distal fibula fractures in the elderly: how to fix them","volume":"12","author":"Sain","year":"2020","unstructured":"Sain AGarg SSharma VMeena UK & Bansal H. Osteoporotic distal fibula fractures in the elderly: how to fix them. Cureus202012 e6552. (https:\/\/doi.org\/10.7759\/cureus.6552)"},{"key":"bib41","series-title":"Journal of Orthopaedics and Traumatology","first-page":"245","article-title":"Intramedullary fixation of distal fibular fractures: a systematic review of clinical and functional outcomes","volume":"15","author":"Jain","year":"2014","unstructured":"Jain SHaughton BA & Brew C. Intramedullary fixation of distal fibular fractures: a systematic review of clinical and functional outcomes. Journal of Orthopaedics and Traumatology201415245\u2013254. (https:\/\/doi.org\/10.1007\/s10195-014-0320-0)"},{"key":"bib42","series-title":"Journal of Foot and Ankle Surgery","first-page":"178","article-title":"Can locked fibula nail replace plate fixation for treatment of acute ankle fracture? A systematic review and meta-analysis","volume":"62","author":"Guo","year":"2023","unstructured":"Guo WWu FChen WTian KZhuang R & Pan Y. Can locked fibula nail replace plate fixation for treatment of acute ankle fracture? A systematic review and meta-analysis. Journal of Foot and Ankle Surgery202362178\u2013185. (https:\/\/doi.org\/10.1053\/j.jfas.2022.10.003)"},{"key":"bib43","series-title":"International Orthopaedics","first-page":"1405","article-title":"Outcomes after primary ankle arthrodesis in recent fractures of the distal end of the tibia in the elderly: a systematic review","volume":"46","author":"Fadhel","year":"2022","unstructured":"Fadhel WBTaieb LVillain BMebtouche NLevante SB\u00e9gu\u00e9 T & Aur\u00e9gan JC. Outcomes after primary ankle arthrodesis in recent fractures of the distal end of the tibia in the elderly: a systematic review. International Orthopaedics2022461405\u20131412. (https:\/\/doi.org\/10.1007\/s00264-022-05317-0)"},{"key":"bib44","series-title":"Ota International","article-title":"Ankle tibiotalocalcaneal nailing in elderly ankle fractures as an alternative to open reduction internal fixation: technique and literature review","volume":"5","author":"Dimitroulias","year":"2022","unstructured":"Dimitroulias A. Ankle tibiotalocalcaneal nailing in elderly ankle fractures as an alternative to open reduction internal fixation: technique and literature review. Ota International20225 e183. (https:\/\/doi.org\/10.1097\/OI9.0000000000000183)"},{"key":"bib45","series-title":"Injury","first-page":"519","article-title":"Fragility fractures of the ankle in the elderly: open reduction and internal fixation versus tibio-talo-calcaneal nailing: short-term results of a prospective randomized-controlled study","volume":"48","author":"Georgiannos","year":"2017","unstructured":"Georgiannos DLampridis V & Bisbinas I. Fragility fractures of the ankle in the elderly: open reduction and internal fixation versus tibio-talo-calcaneal nailing: short-term results of a prospective randomized-controlled study. Injury201748519\u2013524. (https:\/\/doi.org\/10.1016\/j.injury.2016.11.017)"},{"key":"bib46","series-title":"EFORT Open Reviews","first-page":"628","article-title":"Retrograde tibiotalocalcaneal nailing for the treatment of acute ankle fractures in the elderly: a systematic review and meta-analysis","volume":"7","author":"Lu","year":"2022","unstructured":"Lu VTennyson MZhou APatel RFortune MDThahir A & Krkovic M. Retrograde tibiotalocalcaneal nailing for the treatment of acute ankle fractures in the elderly: a systematic review and meta-analysis. EFORT Open Reviews20227628\u2013643. (https:\/\/doi.org\/10.1530\/EOR-22-0017)"},{"key":"bib47","series-title":"Foot and Ankle Specialist","first-page":"543","article-title":"Double plating of distal fibula fractures","volume":"10","author":"Vance","year":"2017","unstructured":"Vance DD & Vosseller JT. Double plating of distal fibula fractures. Foot and Ankle Specialist201710543\u2013546. (https:\/\/doi.org\/10.1177\/1938640017692416)"},{"key":"bib48","series-title":"Orthopedics","first-page":"936","article-title":"Osteoporotic ankle fractures: an approach to operative management","volume":"36","author":"McKean","year":"2013","unstructured":"McKean JCuellar DOHak D & Mauffrey C. Osteoporotic ankle fractures: an approach to operative management. Orthopedics201336936\u2013940. (https:\/\/doi.org\/10.3928\/01477447-20131120-07)"},{"key":"bib49","series-title":"Journal of Foot and Ankle Surgery","first-page":"916","article-title":"Dual nonlocked plating as an alternative to locked plating for comminuted distal fibula fractures: a biomechanical comparison study","volume":"58","author":"Randall","year":"2019","unstructured":"Randall RMNagle TSteckler ABillow D & Berkowitz MJ. Dual nonlocked plating as an alternative to locked plating for comminuted distal fibula fractures: a biomechanical comparison study. Journal of Foot and Ankle Surgery201958916\u2013919. (https:\/\/doi.org\/10.1053\/j.jfas.2019.01.017)"},{"key":"bib50","series-title":"Journal of Foot and Ankle Surgery","first-page":"288","article-title":"Management of complex fibular fractures: double plating of fibular fractures","volume":"54","author":"Kwaadu","year":"2015","unstructured":"Kwaadu KYFleming JJ & Lin D. Management of complex fibular fractures: double plating of fibular fractures. Journal of Foot and Ankle Surgery201554288\u2013294. (https:\/\/doi.org\/10.1053\/j.jfas.2013.08.002)"},{"key":"bib51","series-title":"Foot and Ankle Specialist","first-page":"19386400211017373","article-title":"A comparison of fibula pro-tibia fixation versus hindfoot nailing for unstable fractures of the ankle in those older than 60 years","author":"Eyre-Brook","year":"2021","unstructured":"Eyre-Brook AIRing JChadwick CDavies HDavies M & Blundell C. A comparison of fibula pro-tibia fixation versus hindfoot nailing for unstable fractures of the ankle in those older than 60 years. Foot and Ankle Specialist202119386400211017373. (https:\/\/doi.org\/10.1177\/19386400211017373)"},{"key":"bib52","series-title":"Foot and Ankle International","first-page":"696","article-title":"Comparison of augmentation methods for internal fixation of osteoporotic ankle fractures","volume":"30","author":"Panchbhavi","year":"2009","unstructured":"Panchbhavi VKVallurupalli S & Morris R. Comparison of augmentation methods for internal fixation of osteoporotic ankle fractures. Foot and Ankle International200930696\u2013703. (https:\/\/doi.org\/10.3113\/FAI.2009.0696)"},{"key":"bib53","series-title":"Foot and Ankle Surgery","first-page":"16","article-title":"Percutaneous screw fixation of unstable ankle fractures in patients with poor soft tissues and significant co-morbidities","volume":"23","author":"Smith","year":"2017","unstructured":"Smith MMedlock G & Johnstone AJ. Percutaneous screw fixation of unstable ankle fractures in patients with poor soft tissues and significant co-morbidities. Foot and Ankle Surgery20172316\u201320. (https:\/\/doi.org\/10.1016\/j.fas.2015.11.008)"},{"key":"bib54","series-title":"Journal of Orthopaedic Trauma","first-page":"602","article-title":"Lag screw fixation of medial malleolar fractures: A biomechanical, radiographic, and clinical comparison of unicortical partially threaded lag screws and bicortical fully threaded lag screws","volume":"26","author":"Ricci","year":"2012","unstructured":"Ricci WMTornetta P & Borrelli J. Lag screw fixation of medial malleolar fractures: A biomechanical, radiographic, and clinical comparison of unicortical partially threaded lag screws and bicortical fully threaded lag screws. Journal of Orthopaedic Trauma201226602\u2013606. (https:\/\/doi.org\/10.1097\/BOT.0b013e3182404512)"},{"key":"bib55","series-title":"Archives of Orthopaedic and Trauma Surgery","first-page":"2585","article-title":"Efficacy of hook-type locking plate and partially threaded cancellous lag screw in the treatment of displaced medial malleolar fractures in elderly patients","volume":"142","author":"Cho","year":"2022","unstructured":"Cho BKKim JB & Choi SM. Efficacy of hook-type locking plate and partially threaded cancellous lag screw in the treatment of displaced medial malleolar fractures in elderly patients. Archives of Orthopaedic and Trauma Surgery20221422585\u20132596. (https:\/\/doi.org\/10.1007\/s00402-021-03945-6)"},{"key":"bib56","series-title":"Journal of Foot and Ankle Surgery","first-page":"969","article-title":"Hook plate fixation of medial malleolar fractures: A comparative study of clinical outcomes","volume":"59","author":"Vajapey","year":"2020","unstructured":"Vajapey SP & Harrison RK. Hook plate fixation of medial malleolar fractures: A comparative study of clinical outcomes. Journal of Foot and Ankle Surgery202059969\u2013971. (https:\/\/doi.org\/10.1053\/j.jfas.2018.12.048)"},{"key":"bib57","series-title":"Orthopaedic Surgery","first-page":"203","article-title":"HbA1c and diabetic ankle fractures","volume":"5","author":"Liu","year":"2013","unstructured":"Liu JLudwig T & Ebraheim NA. HbA1c and diabetic ankle fractures. Orthopaedic Surgery20135203\u2013208. (https:\/\/doi.org\/10.1111\/os.12047)"},{"key":"bib58","series-title":"Journal of Foot and Ankle Surgery","first-page":"207","article-title":"Factors associated with nonunion, delayed union, and malunion in foot and ankle surgery in diabetic patients","volume":"52","author":"Shibuya","year":"2013","unstructured":"Shibuya NHumphers JMFluhman BL & Jupiter DC. Factors associated with nonunion, delayed union, and malunion in foot and ankle surgery in diabetic patients. Journal of Foot and Ankle Surgery201352207\u2013211. (https:\/\/doi.org\/10.1053\/j.jfas.2012.11.012)"},{"key":"bib59","series-title":"Archives of Orthopaedic and Trauma Surgery","first-page":"1","article-title":"Pedobarographic evaluation of five commonly used orthoses for the lower extremity","author":"Ehrnthaller","year":"2022","unstructured":"Ehrnthaller CRellensmann KBaumbach SFWuehr MSchniepp RSaller MMB\u00f6cker W & Polzer H. Pedobarographic evaluation of five commonly used orthoses for the lower extremity. Archives of Orthopaedic and Trauma Surgery20221\u20138. (https:\/\/doi.org\/10.1007\/s00402-022-04729-2)"},{"key":"bib60","series-title":"Archives of Orthopaedic and Trauma Surgery","first-page":"3311","article-title":"An overview on the treatment and outcome factors of ankle fractures in elderly men and women aged 80 and over: a systematic review","volume":"142","author":"Halsema van","year":"2022","unstructured":"Halsema van MSBoers RAR & Leferink VJM. An overview on the treatment and outcome factors of ankle fractures in elderly men and women aged 80 and over: a systematic review. Archives of Orthopaedic and Trauma Surgery20221423311\u20133325. (https:\/\/doi.org\/10.1007\/s00402-021-04161-y)"}],"container-title":["EFORT Open Reviews"],"original-title":[],"link":[{"URL":"https:\/\/eor.bioscientifica.com\/view\/journals\/eor\/8\/5\/EOR-23-0052.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/eor.bioscientifica.com\/downloadpdf\/journals\/eor\/8\/5\/EOR-23-0052.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/eor.bioscientifica.com\/downloadpdf\/journals\/eor\/8\/5\/EOR-23-0052.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:51:03Z","timestamp":1784555463000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/eor\/article\/8\/5\/223-230\/2546"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,1]]},"references-count":60,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.1530\/eor-23-0052","relation":{},"ISSN":["2058-5241"],"issn-type":[{"value":"2058-5241","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,1]]}}}