Evidence map›Paper›PMID 28348185›Full record

Trial reportBMJ open2017

Surgery for Type B Ankle Fracture Treatment: a Combined Randomised and Observational Study (CROSSBAT).

Rajat Mittal, Ian A Harris, Sam Adie, Justine M Naylor, CROSSBAT Study Group

3 registry-linked trialsOpen access · goldAbstract readMulticenter StudyObservational StudyPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 27 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 6 pooled it
4.2field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01134094 nacompletednot on this map

Combined Randomised and Observational Study of Type B Ankle Fracture Treatment

TypeinterventionalSponsorThe University of New South WalesRan2010 to 2014Enrolled160ConditionsAnkle FracturesArmsOpen reduction internal fixation of the ankle, Non Operative
NCT04164563 naterminatednot on this mapstarted 2019, after this paper: background citation

A Randomized Controlled Trial of Non-Operative Ankle Fractures: Even-Up Orthotic Shoe Lift and CAM Walking Boot Wear

TypeinterventionalSponsorBrigham and Women's HospitalRan2019 to 2020Enrolled6ConditionsArthralgia, Trouble BalancingArmsEven-Up
NCT04623346 unknown statusnot on this mapstarted 2020, after this paper: background citation

Orthopaedic Conservative Treatment in the Time of Covid-19 Pandemic

TypeobservationalSponsorProf. Dr. Cemil Tascıoglu Education and Research Hospital OrganizationRan2020 to 2020Enrolled262ConditionsAnkle Fractures, Proximal Humeral Fracture, Wrist FractureArmsObservation for study group
3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 6 syntheses or guidelines pooled it, 62 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Cast versus removable orthosis for the management of stable type B ankle fractures: a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  8. Trial
  9. Trial
  10. Trial
  11. The Diagnosis, Treatment, and Aftercare of Ankle Fractures.Deutsches Arzteblatt international · 2026
    Review
  12. Article
  13. Review
  14. Lag screw versus no lag screw in surgery for Weber B ankle fractures: impact on recovery and surgical outcomes.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Article
  15. Article
  16. Article
  17. Variability in amount of weight-bearing while performing weight-bearing radiographs for assessing stability of ankle fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024
    Article
  18. Article
  19. Article
  20. [Factors associated with functionality in patients with closed ankle fracture].Revista medica del Instituto Mexicano del Seguro Social · 2023
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Rajat MittalOrthopaedic Department, Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Australia, Liverpool BC, New South Wales, Australia.ORCID 0000-0002-0852-8868
Ian A HarrisOrthopaedic Department, Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Australia, Liverpool BC, New South Wales, Australia.
Sam AdieOrthopaedic Department, Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Australia, Liverpool BC, New South Wales, Australia.ORCID 0000-0003-0780-4338
Justine M NaylorOrthopaedic Department, Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Australia, Liverpool BC, New South Wales, Australia.
CROSSBAT Study Group
Ingham Institute · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIsolated type B ankle fractures with no injury to the medial side are the most common type of ankle fracture.

objectiveThis study aimed to determine if surgery is superior to non-surgical management for the treatment of these fractures.

methodsA pragmatic, multicentre, single-blinded, combined randomised controlled trial and observational study. Setting Participants between 18 and 65 years with a type B ankle fracture and minimal talar shift were recruited from 22 hospitals in Australia and New Zealand. Participants willing to be randomised were randomly allocated to undergo surgical fixation followed by mobilisation in a walking boot for 6 weeks. Those treated non-surgically were managed in a walking boot for 6 weeks. Participants not willing to be randomised formed the observational cohort. Randomisation stratified by site and using permuted variable blocks was administered centrally. Outcome assessors were blinded for the primary outcomes. Primary outcomes Patient-reported ankle function using the American Academy of Orthopaedic Surgeons Foot and Ankle Outcomes Questionnaire (FAOQ) and the physical component score (PCS) of the SF-12v2 General Health Survey at 12 months postinjury. Primary analysis was intention to treat; the randomised and observational cohorts were analysed separately.

resultsFrom August 2010 to October 2013, 160 people were randomised (80 surgical and 80 non-surgical); 139 (71 surgical and 68 non-surgical) were analysed as intention to treat. 276 formed the observational cohort (19 surgical and 257 non-surgical); 220 (18 surgical and 202 non-surgical) were analysed. The randomised cohort demonstrated that surgery was not superior to non-surgery for the FAOQ (49.8 vs 53.0; mean difference 3.2 (95% CI 0.4 to 5.9), p=0.028), or the PCS (53.7 vs 53.2; mean difference 0.6 (-2.9 to 1.8), p=0.63). 23 (32%) and 10 (14%) participants had an adverse event in the surgical and non-surgical groups, respectively. Similar results were found in the observational cohort.

conclusionsSurgery is not superior to non-surgical management for 44-B1 ankle fractures in the short term, and is associated with increased adverse events. TRIAL REGISTRATION NUMBER: NCT01134094.

Indexed as

Conservative TreatmentFracture FixationAdultAnkle FracturesAustraliaFemaleHumansMaleNew ZealandOrthotic DevicesPatient CompliancePhysical Therapy ModalitiesRange of Motion, ArticularRecovery of FunctionTreatment OutcomeORTHOPAEDIC & TRAUMA SURGERY

Identifiers

PMID28348185
PMCPMC5372107
OpenAlexW2601508209

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.