Evidence map›Paper›PMID 37335355›Full record

ArticleArchives of orthopaedic and trauma surgery2023

Two-staged management of ankle fracture-dislocations with a posterior fragment: computer-tomography-based classification, treatment and its outcome.

Method Kabelitz, Nina Kabelitz, Herman Frima, Philipp Florian Stillhard, Christoph Sommer, Christian Michelitsch

Abstract read
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In one paragraph

Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 33% 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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Swollen Ankle Fractures: What Predicts Delays in Definitive Fixation?Journal of clinical practice and research · 2025
    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 3 institutions in 2 countries.

Method KabelitzClinic of Orthopedics, Hand and Trauma Surgery, City Hospital Zurich, Tièchestrasse 99, 8037, Zurich, Switzerland. kabelitz.method@gmail.com.ORCID http://orcid.org/0000-0001-8946-9304
Nina KabelitzDepartment of Trauma Surgery, Kantonsspital Graubünden, Loëstrasse 170, 7000, Chur, Switzerland.
Herman FrimaDepartment of Trauma Surgery, Noordwest Ziekenhuisgroep, Wilhelminalaan 12, 1815 JD, Alkmaar, Netherlands.
Philipp Florian StillhardDepartment of Trauma Surgery, Kantonsspital Graubünden, Loëstrasse 170, 7000, Chur, Switzerland.
Christoph SommerDepartment of Trauma Surgery, Kantonsspital Graubünden, Loëstrasse 170, 7000, Chur, Switzerland.
Christian MichelitschDepartment of Trauma Surgery, Kantonsspital Graubünden, Loëstrasse 170, 7000, Chur, Switzerland.
Kantonsspital Graubünden · CHNoordwest Ziekenhuisgroep · NLTriemli Hospital · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTrimalleolar fractures are difficult to treat and malreduction can lead to functional impairment. Involvement of the posterior malleolus has a poor predictive value. Current computed-tomography (CT)-based fracture classifications led to an increase in fixation of the posterior malleolus. The aim of this study was to describe the functional outcome after a two-stage stabilisation with direct fixation of the posterior fragment in trimalleolar dislocation fractures. MATERIALS AND

methodsIn a retrospective study, all patients presenting with a trimalleolar dislocation fracture, an available CT scan, and a two-stage operative stabilisation including the posterior malleolus by a posterior approach were included. All fractures were treated with initial external fixator and delayed definitive stabilisation including fixation of the posterior malleolus. Next to clinical and radiological follow-up, outcome measures (Foot and Ankle Outcome Score (FAOS), Numeric Rating Scale (NRS), Activity of Daily Living (ADL), Hulsmans implant removal score) and complications were analysed.

resultsBetween 2008 and 2019, of 320 trimalleolar dislocation fractures, 39 patients were included. Mean follow-up was 49 months (standard deviation (SD) 29.7, range 16-148). Mean age was 60 years (SD 15.3, 17-84) with 69% female patients. The mean FAOS was 93/100 (SD 9.7, 57-100), NRS 2 (interquartile range (IQR) 0-3) and ADL 2 (IQR 1-2). Four patients showed a postoperative infection, three re-operations had to be performed and implants were removed in 24 individuals.

conclusionA two-stage procedure of trimalleolar dislocation fractures with in-direct reduction and fixation of the posterior tibial fragment through a posterior approach leads to good functional outcome scores with a low rate of complications.

Indexed as

Ankle FracturesFracture DislocationJoint DislocationsAnkleAnkle JointFemaleFracture Fixation, InternalHumansMaleMiddle AgedRetrospective StudiesTomography, X-Ray ComputedTreatment OutcomeAnkle fractureAnkle joint osteoarthritisComputed-tomographic fracture classificationOsteosynthesis

Identifiers

PMID37335355
OpenAlexW4381164995

What OpenQuestion holds

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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.