{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:10:08Z","timestamp":1785402608743,"version":"3.56.0"},"reference-count":30,"publisher":"Akademiai Kiado Zrt.","issue":"10","content-domain":{"domain":["www.akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2025,3,9]]},"abstract":"Az id\u0151s\u00f6d\u0151 p\u00e1ciensekn\u00e9l el\u0151fordul\u00f3 bokat\u00f6r\u00e9sek egy\u00e9rtelm\u0171 emelked\u0151 tendenci\u00e1t\n mutatnak. Megfelel\u0151 ter\u00e1pi\u00e1juk azonban gyakran kih\u00edv\u00e1st jelent, mely ak\u00e1r nagy\n komplik\u00e1ci\u00f3s r\u00e1t\u00e1val t\u00e1rsulhat. A fokozott sz\u00f6v\u0151dm\u00e9nyr\u00e1ta f\u0151 okak\u00e9nt a\n betegpopul\u00e1ci\u00f3 saj\u00e1toss\u00e1gai nevezhet\u0151k meg, \u00fagymint a gyakran \u00f6sszetett\n alapbetegs\u00e9gek, a gyeng\u00fclt csontozat, illetve a kor\u00e1ntsem optim\u00e1lis\n l\u00e1gyr\u00e9sz-viszonyok. A probl\u00e9m\u00e1k pedig gyakrabban jelentkezhetnek az am\u00fagy is\n \u00e9rz\u00e9keny l\u00e1gy r\u00e9szekre kifejezett negat\u00edv hat\u00e1ssal l\u00e9v\u0151 standard, invaz\u00edv\n operat\u00edv m\u00f3dszerek, mint a lemezes osteosynthesis mellett. A geri\u00e1triai\n p\u00e1ciensek t\u00f6bbes, \u00f6sszetett bokat\u00f6r\u00e9seinek kezel\u00e9s\u00e9vel \u00f6sszef\u00fcgg\u0151 komplik\u00e1ci\u00f3k\n cs\u00f6kkent\u00e9s\u00e9re a l\u00e1gy r\u00e9szeket k\u00edm\u00e9l\u0151 kezel\u00e9si alternat\u00edva lehet a distalis\n fibula vel\u0151\u0171rszegez\u00e9se. Jelen esetbemutat\u00e1sunk sor\u00e1n egy 86 \u00e9ves \u00e9s egy 74 \u00e9ves\n p\u00e1ciens komplex ficamos bokat\u00f6r\u00e9s\u00e9nek ter\u00e1pi\u00e1ja p\u00e9ld\u00e1j\u00e1n sz\u00e1nd\u00e9kozunk bemutatni\n az anat\u00f3miai fibula-vel\u0151\u0171rszegez\u00e9si m\u00f3dszer el\u0151nyeit. A bemutatott m\u00f3dszer\n kifejezett l\u00e1gyr\u00e9sz-k\u00edm\u00e9let mellett biztos\u00edt anat\u00f3miai r\u00f6gz\u00edt\u00e9st, mely a m\u0171t\u00e9tet\n k\u00f6vet\u0151en ak\u00e1r (r\u00e9sz)terhelhet\u0151, \u00edgy el\u0151seg\u00edti a p\u00e1ciensek korai mobiliz\u00e1ci\u00f3j\u00e1t\n is. Az elj\u00e1r\u00e1s megfelel\u0151 indik\u00e1ci\u00f3t k\u00f6vet\u0151en kifejezetten j\u00f3 eredm\u00e9nyekkel\n alkalmazhat\u00f3 alternat\u00edva lehet a geri\u00e1triai p\u00e1ciensek bokat\u00f6r\u00e9seinek operat\u00edv\n ter\u00e1pi\u00e1ja sor\u00e1n. Orv Hetil. 2025; 166(10): 392\u2013397.<\/jats:p>","DOI":"10.1556\/650.2025.33242","type":"journal-article","created":{"date-parts":[[2025,3,9]],"date-time":"2025-03-09T11:21:22Z","timestamp":1741519282000},"page":"392-397","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":0,"title":["\u00d6sszetett bokat\u00f6r\u00e9sek l\u00e1gyr\u00e9sz-k\u00edm\u00e9l\u0151 operat\u00edv kezel\u00e9se id\u0151s p\u00e1cienseken fibulaszegez\u00e9ssel"],"prefix":"10.1556","volume":"166","author":[{"given":"M\u00e1t\u00e9","family":"Burkus","sequence":"first","affiliation":[{"name":"Die Filderklinik, \u00c1ltal\u00e1nos, Hasi, Mellkasi \u00e9s Balesetseb\u00e9szet, Seb\u00e9szeti Ortop\u00e9dia Im Haberschlai 7, 70794 Filderstadt, Baden-W\u00fcrttemberg N\u00e9metorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Bruch","sequence":"additional","affiliation":[{"name":"Die Filderklinik, \u00c1ltal\u00e1nos, Hasi, Mellkasi \u00e9s Balesetseb\u00e9szet, Seb\u00e9szeti Ortop\u00e9dia Im Haberschlai 7, 70794 Filderstadt, Baden-W\u00fcrttemberg N\u00e9metorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Kannus P, Palvanen M, Niemi S, et al. Stabilizing incidence of\n low-trauma ankle fractures in elderly people Finnish statistics in 1970\u20132006 and\n prediction for the future. Bone 2008; 43: 340\u2013342.","DOI":"10.1016\/j.bone.2008.04.015"},{"key":"R2","doi-asserted-by":"crossref","unstructured":"Bariteau JT, Hsu RY, Mor V, et al. Operative versus nonoperative\n treatment of geriatric ankle fractures: a Medicare Part A claims database\n analysis. Foot Ankle Int. 2015; 36: 648\u2013655.","DOI":"10.1177\/1071100715573707"},{"key":"R3","doi-asserted-by":"crossref","unstructured":"Ziegler P, Bahrs C, Konrads C, et al. Ankle fractures of the\n geriatric patient: a narrative review. EFORT Open Rev. 2023; 8:\n 1\u201310.","DOI":"10.1530\/EOR-22-0082"},{"key":"R4","doi-asserted-by":"crossref","unstructured":"Burkus M, Bruch A, Bergmann EM, et al. Excellent functional outcomes\n after operative treatment of multifragmentary, dislocated proximal humeral\n fractures in patients over 65 years of age. [Jelent\u0151s funkcion\u00e1lis eredm\u00e9nyek a\n 65 \u00e9v feletti p\u00e1ciensek t\u00f6bbr\u00e9szes, elmozdult proximalis humerust\u00f6r\u00e9seinek\n osteosynthesis\u00e9t k\u00f6vet\u0151en.] Orv Hetil. 2024; 165: 775\u2013784.\n [Hungarian]","DOI":"10.1556\/650.2024.33048"},{"key":"R5","doi-asserted-by":"crossref","unstructured":"Lee KM, Chung CY, Kwon SS, et al. Ankle fractures have features of\n an osteoporotic fracture. Osteoporos Int. 2013; 24: 2819\u20132825.","DOI":"10.1007\/s00198-013-2394-6"},{"key":"R6","doi-asserted-by":"crossref","unstructured":"Greenfield DM, Eastell R. Risk factors for ankle fracture.\n Osteoporos Int. 2001; 12: 97\u2013103.","DOI":"10.1007\/s001980170140"},{"key":"R7","doi-asserted-by":"crossref","unstructured":"Raschke MJ, Ochman S, Milstrey A. Ankle fractures in the elderly: do\n we have new concepts? EFORT Open Rev. 2023; 8: 223\u2013230.","DOI":"10.1530\/EOR-23-0052"},{"key":"R8","doi-asserted-by":"crossref","unstructured":"Makwana NK, Bhowal B, Harper WM, et al. Conservative versus\n operative treatment for displaced ankle fractures in patients over 55 years of\n age. A prospective, randomised study. J Bone Joint Surg Br. 2001; 83:\n 525\u2013529.","DOI":"10.1302\/0301-620X.83B4.0830525"},{"key":"R9","doi-asserted-by":"crossref","unstructured":"Zaghloul A, Haddad B, Barksfield R, et al. Early complications of\n surgery in operative treatment of ankle fractures in those over 60: a review of\n 186 cases. Injury 2014; 45: 780\u2013783.","DOI":"10.1016\/j.injury.2013.11.008"},{"key":"R10","doi-asserted-by":"crossref","unstructured":"Lynde MJ, Sautter T, Hamilton GA, et al. Complications after open\n reduction and internal fixation of ankle fractures in the elderly. Foot Ankle\n Surg. 2012; 18: 103\u2013107.","DOI":"10.1016\/j.fas.2011.03.010"},{"key":"R11","doi-asserted-by":"crossref","unstructured":"Srinivasan CM, Moran CG. Internal fixation of ankle fractures in the\n very elderly. Injury 2001; 32: 559\u2013563.","DOI":"10.1016\/S0020-1383(01)00034-1"},{"key":"R12","doi-asserted-by":"crossref","unstructured":"Hsu RY, Lee Y, Hayda R, et al. Morbidity and mortality associated\n with geriatric ankle fractures. A Medicare Part A Claims Database Analysis. J\n Bone Joint Surg Am. 2015; 97: 1748\u20131755.","DOI":"10.2106\/JBJS.O.00095"},{"key":"R13","doi-asserted-by":"crossref","unstructured":"SooHoo NF, Krenek L, Eagan MJ, et al. Complication rates following\n open reduction and internal fixation of ankle fractures. J Bone Joint Surg Am.\n 2009; 91: 1042\u20131049.","DOI":"10.2106\/JBJS.H.00653"},{"key":"R14","doi-asserted-by":"crossref","unstructured":"Riedel MD, Parker A, Zheng M, et al. Correlation of soft tissue\n swelling and timing to surgery with acute wound complications for operatively\n treated ankle and other lower extremity fractures. Foot Ankle Int. 2019; 40:\n 526\u2013536.","DOI":"10.1177\/1071100718820352"},{"key":"R15","doi-asserted-by":"crossref","unstructured":"Zahn RK, Frey S, Jakubietz RG, et al. A contoured locking plate for\n distal fibular fractures in osteoporotic bone: a biomechanical cadaver study.\n Injury 2012; 43: 718\u2013725.","DOI":"10.1016\/j.injury.2011.07.009"},{"key":"R16","doi-asserted-by":"crossref","unstructured":"Aigner R, Lechler P, Boese CK, et al. Operative treatment of\n geriatric ankle fractures with conventional or locking plates. A retrospective\n case-control study. Foot Ankle Surg. 2019; 25: 766\u2013770.","DOI":"10.1016\/j.fas.2018.10.002"},{"key":"R17","doi-asserted-by":"crossref","unstructured":"Cho BK, Kim JB, Choi SM. Efficacy of hook-type locking plate and\n partially threaded cancellous lag screw in the treatment of displaced medial\n malleolar fractures in elderly patients. Arch Orthop Trauma Surg. 2022; 142:\n 2585\u20132596.","DOI":"10.1007\/s00402-021-03945-6"},{"key":"R18","doi-asserted-by":"crossref","unstructured":"King CM, Cobb M, Collman DR, et al. Bicortical fixation of medial\n malleolar fractures: a review of 23 cases at risk for complicated bone healing.\n J Foot Ankle Surg. 2012; 51: 39\u201344.","DOI":"10.1053\/j.jfas.2011.09.007"},{"key":"R19","doi-asserted-by":"crossref","unstructured":"Hsu RY, Ramirez JM, Blankenhorn BD. Surgical considerations for\n osteoporosis in ankle fracture fixation. Orthop Clin North Am. 2019; 50:\n 245\u2013258.","DOI":"10.1016\/j.ocl.2018.10.007"},{"key":"R20","doi-asserted-by":"crossref","unstructured":"Andruszkow H, Pfeifer R, Horst K, et al. External fixation in the\n elderly. Injury 2015; 46(Suppl 3): S7\u2013S12.","DOI":"10.1016\/S0020-1383(15)30004-8"},{"key":"R21","doi-asserted-by":"crossref","unstructured":"Srinath A, Matuszewski PE, Kalbac T. Geriatric ankle fracture:\n robust fixation versus hindfoot nail. J Orthop Trauma 2021; 35(Suppl 5):\n S41\u2013S44.","DOI":"10.1097\/BOT.0000000000002232"},{"key":"R22","doi-asserted-by":"crossref","unstructured":"Luong K, Huchital MJ, Saleh AM, et al. Management of distal fibular\n fractures with minimally invasive technique: a systematic review. J Foot Ankle\n Surg. 2021; 60: 114\u2013120.","DOI":"10.1053\/j.jfas.2020.05.017"},{"key":"R23","doi-asserted-by":"crossref","unstructured":"Asloum Y, Bedin B, Roger T, et al. Internal fixation of the fibula\n in ankle fractures: a prospective, randomized and comparative study: plating\n versus nailing. Orthop Traumatol Surg Res. 2014; 100(Suppl 4):\n S255\u2013S259.","DOI":"10.1016\/j.otsr.2014.03.005"},{"key":"R24","doi-asserted-by":"crossref","unstructured":"White TO, Bugler KE, Appleton P, et al. A prospective randomised\n controlled trial of the fibular nail versus standard open reduction and internal\n fixation for fixation of ankle fractures in elderly patients. Bone Joint J.\n 2016; 98-B(9): 1248\u20131252.","DOI":"10.1302\/0301-620X.98B9.35837"},{"key":"R25","doi-asserted-by":"crossref","unstructured":"Tas DB, Smeeing DPJ, Emmink BL, et al. Intramedullary fixation\n versus plate fixation of distal fibular fractures. A systematic review and\n meta-analysis of randomized controlled trials and observational studies. J Foot\n Ankle Surg. 2019; 58: 119\u2013126.","DOI":"10.1053\/j.jfas.2018.08.028"},{"key":"R26","doi-asserted-by":"crossref","unstructured":"Jain S, Haughton BA, Brew C. Intramedullary fixation of distal\n fibular fractures: a systematic review of clinical and functional outcomes. J\n Orthop Traumatol. 2014; 15: 245\u2013254.","DOI":"10.1007\/s10195-014-0320-0"},{"key":"R27","doi-asserted-by":"crossref","unstructured":"Carter TH, Wallace R, Mackenzie SA, et al. The fibular\n intramedullary nail versus locking plate and lag screw fixation in the\n management of unstable elderly ankle fractures. A cadaveric biomechanical\n comparison. J Orthop Trauma 2020; 34: e401\u2013e406.","DOI":"10.1097\/BOT.0000000000001814"},{"key":"R28","doi-asserted-by":"crossref","unstructured":"Swart E, Bezhani H, Greisberg J, et al. How long should patients be\n kept non-weight bearing after ankle fracture fixation? A survey of OTA and AOFAS\n members. Injury 2015; 46: 1127\u20131130.","DOI":"10.1016\/j.injury.2015.03.029"},{"key":"R29","doi-asserted-by":"crossref","unstructured":"Schepers T. To retain or remove the syndesmotic screw: a review of\n literature. Arch Orthop Trauma Surg. 2011; 131: 879\u2013883.","DOI":"10.1007\/s00402-010-1225-x"},{"key":"R30","doi-asserted-by":"crossref","unstructured":"Bak\u00f3 Gy. The situation of geriatric medicine in Hungary today. [A\n geri\u00e1tria helyzete ma Magyarorsz\u00e1gon.] Orv Hetil. 2023; 164: 891\u2013893.\n [Hungarian]","DOI":"10.1556\/650.2023.32807"}],"container-title":["Orvosi Hetilap"],"original-title":[],"link":[{"URL":"https:\/\/www.akjournals.com\/view\/journals\/650\/166\/10\/article-p392.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.akjournals.com\/downloadpdf\/journals\/650\/166\/10\/article-p392.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.akjournals.com\/downloadpdf\/journals\/650\/166\/10\/article-p392.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T08:06:15Z","timestamp":1785398775000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.akjournals.com\/view\/journals\/650\/166\/10\/article-p392.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,9]]},"references-count":30,"journal-issue":{"issue":"10"},"URL":"https:\/\/doi.org\/10.1556\/650.2025.33242","relation":{},"ISSN":["0030-6002","1788-6120"],"issn-type":[{"value":"0030-6002","type":"print"},{"value":"1788-6120","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,9]]}}}