Evidence map›Paper›PMID 35505429›Full record

ArticleJournal of orthopaedic surgery and research2022

Surgical treatment of displaced isolated lateral malleolar fractures: incidence of adverse events requiring revision: a retrospective cohort study.

Jonas Ordell Frederiksen, Catarina Malmberg, Dennis Karimi, Peter Toft Tengberg, Anders Troelsen, Mads Terndrup

Open access · goldAbstract read
In one paragraph

Article in Journal of orthopaedic surgery and research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 45% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Article
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

6 authors at 1 institution in 1 country.

Jonas Ordell FrederiksenDepartment of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, Kettegårdsalle 30, 2650, Hvidovre, Denmark. ordell.jonas@gmail.com.ORCID http://orcid.org/0000-0001-9848-6915
Catarina MalmbergDepartment of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, Kettegårdsalle 30, 2650, Hvidovre, Denmark.
Dennis KarimiDepartment of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, Kettegårdsalle 30, 2650, Hvidovre, Denmark.
Peter Toft TengbergDepartment of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, Kettegårdsalle 30, 2650, Hvidovre, Denmark.
Anders TroelsenDepartment of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, Kettegårdsalle 30, 2650, Hvidovre, Denmark.
Mads TerndrupDepartment of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, Kettegårdsalle 30, 2650, Hvidovre, Denmark.
Hvidovre Hospital · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent systematic reviews support that non-operative management should be the standard treatment for all stable isolated lateral malleolar fractures (ILMFs), regardless of fibular fracture displacement. Surgical fixation of ILMFs carries a risk of adverse events (AEs), and many patients will later require implant removal. We wanted to estimate the incidence of AEs requiring revision after surgical fixation of "potentially stable" displaced ILMFs before non-operative treatment became standard care in our department. MATERIALS AND

methodsTo identify patients with "potentially stable" ILMFs who had been treated surgically in a historical cohort, we retrospectively applied the stability-based classification system, introduced by Michelson et al., to a cohort of 1006 patients with ankle fractures treated surgically from 2011 to 2016. The primary outcome of this retrospective cohort study was the incidence of AEs that had functionally significant adverse effects on outcome and required revision in the first 12 months after surgery. AEs were graded and categorized using the Orthopedic Surgical Adverse Events Severity (OrthoSAVES) System.

resultsThe study population comprised 108 patients with "potentially stable" displaced ILMFs; 4 patients (3.7% [95% CI (0.1-7.3%]) experienced AEs requiring revision in the first twelve months after surgery. There were 5 additional patients (4.6%) with functionally significant AEs where revision surgery was not indicated within the first twelve months after surgical fixation. A further 5 patients (4.6%) had AEs managed in the outpatient clinic (grade II); 36 patients (33.3%) required secondary implant removal due to implant-related discomfort.

conclusionsSurgical fixation of ILMFs carries a risk of severe AEs, and many patients will subsequently need implant-removal procedures. Further prospective studies are required to ascertain whether non-operative treatment can lower the risk of AEs and the need for additional surgical procedures.

Indexed as

Ankle FracturesCohort StudiesHumansIncidenceProspective StudiesRetrospective StudiesAdverse eventsAnkle fracturesIsolated lateral malleolar fracturesStability-based classificationTalar shift

Identifiers

PMID35505429
PMCPMC9066775
OpenAlexW4225318201

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.