Minimum 5-Year Follow-up Results: CROSSBAT (Combined Randomised and Observational Study of Surgery vs No Surgery for Type B Ankle Fracture Treatment)

Isolated Weber B, AO (Association for the Study of Internal Fixation) type 44B ankle fractures with no fracture to the medial side are the most common type of ankle fracture and may be treated with internal fixation or without surgery.This study aimed to determine if surgery is superior to nonsurgic...

Full description

Saved in:
Bibliographic Details
Published inFoot & ankle international Vol. 43; no. 12; p. 1517
Main Authors O'Keefe, Ryan, Naylor, Justine M, Symes, Michael J, Harris, Ian A, Mittal, Rajat
Format Journal Article
LanguageEnglish
Published United States 01.12.2022
Subjects
Online AccessGet more information

Cover

Loading…
Abstract Isolated Weber B, AO (Association for the Study of Internal Fixation) type 44B ankle fractures with no fracture to the medial side are the most common type of ankle fracture and may be treated with internal fixation or without surgery.This study aimed to determine if surgery is superior to nonsurgical management for the treatment of these fractures after a minimum 5-year follow-up. A pragmatic, multicenter, single-masked, randomized controlled trial with minimum 5-year follow-up. : Participants between 18 and 65 years with AO type 44B ankle fracture and minimal talar shift were recruited from 22 hospitals in Australia and New Zealand. Participants willing to be randomized were randomly allocated to undergo surgical fixation followed by mobilization in a walking boot for 6 weeks. Those treated nonsurgically were managed in a walking boot for 6 weeks. Outcome assessors were masked for the treatment allocation. : Patient-reported ankle function using the American Academy of Orthopaedic Surgeons Foot and Ankle Outcomes Questionnaire (FAOQ) and the physical component summary (PCS) of the SF-12v2 General Health Survey at 12 months postinjury and at minimum 5 years post injury. Primary analysis was intention-to-treat. Of the 160 (80 surgical, 80 nonoperative) randomized patients included in the CROSSBAT analysis, 77 (40 surgical, 37 nonoperative) were followed up for repeat analysis at minimum 5-year follow-up (mean 7.3 years, range 5.1-8.9). This cohort demonstrated that surgery was not associated with clinically or statistically significant differences compared to nonoperative management for the FAOQ (51.7 vs 49.6; mean difference 2.1, 95% CI -2.1 to 6.2, = .95), or the PCS (51.5 vs 49.1; mean difference 2.3, 95% CI -2.0 to 6.7, = .54). The surgical cohort had a higher rate of any adverse events (odds ratio 3.7, 95% CI 1.2-11.6, = .04). The results of this study suggest that surgical management is not superior to nonsurgical management in type B ankle (fibula) fractures with minimal talar shift over a 5-year period and is associated with increased adverse events. Level II, randomized clinical trial.
AbstractList Isolated Weber B, AO (Association for the Study of Internal Fixation) type 44B ankle fractures with no fracture to the medial side are the most common type of ankle fracture and may be treated with internal fixation or without surgery.This study aimed to determine if surgery is superior to nonsurgical management for the treatment of these fractures after a minimum 5-year follow-up. A pragmatic, multicenter, single-masked, randomized controlled trial with minimum 5-year follow-up. : Participants between 18 and 65 years with AO type 44B ankle fracture and minimal talar shift were recruited from 22 hospitals in Australia and New Zealand. Participants willing to be randomized were randomly allocated to undergo surgical fixation followed by mobilization in a walking boot for 6 weeks. Those treated nonsurgically were managed in a walking boot for 6 weeks. Outcome assessors were masked for the treatment allocation. : Patient-reported ankle function using the American Academy of Orthopaedic Surgeons Foot and Ankle Outcomes Questionnaire (FAOQ) and the physical component summary (PCS) of the SF-12v2 General Health Survey at 12 months postinjury and at minimum 5 years post injury. Primary analysis was intention-to-treat. Of the 160 (80 surgical, 80 nonoperative) randomized patients included in the CROSSBAT analysis, 77 (40 surgical, 37 nonoperative) were followed up for repeat analysis at minimum 5-year follow-up (mean 7.3 years, range 5.1-8.9). This cohort demonstrated that surgery was not associated with clinically or statistically significant differences compared to nonoperative management for the FAOQ (51.7 vs 49.6; mean difference 2.1, 95% CI -2.1 to 6.2, = .95), or the PCS (51.5 vs 49.1; mean difference 2.3, 95% CI -2.0 to 6.7, = .54). The surgical cohort had a higher rate of any adverse events (odds ratio 3.7, 95% CI 1.2-11.6, = .04). The results of this study suggest that surgical management is not superior to nonsurgical management in type B ankle (fibula) fractures with minimal talar shift over a 5-year period and is associated with increased adverse events. Level II, randomized clinical trial.
Author Symes, Michael J
Mittal, Rajat
Naylor, Justine M
Harris, Ian A
O'Keefe, Ryan
Author_xml – sequence: 1
  givenname: Ryan
  orcidid: 0000-0002-3928-7892
  surname: O'Keefe
  fullname: O'Keefe, Ryan
  organization: Royal North Shore Hospital, St Leonards, New South Wales, Australia
– sequence: 2
  givenname: Justine M
  surname: Naylor
  fullname: Naylor, Justine M
  organization: Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Liverpool, NSW, Australia
– sequence: 3
  givenname: Michael J
  orcidid: 0000-0002-4613-2653
  surname: Symes
  fullname: Symes, Michael J
  organization: Department of Orthopaedic Surgery St George Hospital, Kogarah, NSW, Australia; Orthopaedic Foot and Ankle Research Institute (SOFARI), Sydney, NSW, Australia; St George and Sutherland Clinical School, University of New South Wales Medicine, Kogarah, NSW, Australia
– sequence: 4
  givenname: Ian A
  orcidid: 0000-0003-0887-7627
  surname: Harris
  fullname: Harris, Ian A
  organization: Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Liverpool, NSW, Australia
– sequence: 5
  givenname: Rajat
  orcidid: 0000-0002-0852-8868
  surname: Mittal
  fullname: Mittal, Rajat
  organization: Sydney Orthopaedic Foot and Ankle Research Institute (SOFARI), Sydney, NSW, Australia
BackLink https://www.ncbi.nlm.nih.gov/pubmed/36373545$$D View this record in MEDLINE/PubMed
BookMark eNo9kLtOwzAYRi0EorTwACzoH2EI2LnYDlsbUUAqVGrCwFQ5vqBAEkd2UpQH4X2pxGU65yzf8E3RYWtbjdA5wdeEMHZDMCMEYxaGhIQ8oeEBOiFpHAeMMzpBU-_fMSYsIukxmkQ0YlESJyfo66lqq2ZoIAletXCwtHVtP4Ohg432Q937W8g26zxfzAu4zGxTVq1WsBGtsk3l97o3WJdeu53oK9uKGvJ-UCNYA_ng3rQbYefh2f6XsQ6KsdOwgHn7UWtYOiH7wWkonBZ9o9v-6hQdGVF7ffbLGXpZ3hXZQ7Ba3z9m81UgQ4b7gPJISZVSWQoRccalThiNCDY6MQRLFouUhibVRjEpOJdpaaRSmErKTRxzE87Qxc9uN5SNVtvOVY1w4_bvn_AbFaBpOw
CitedBy_id crossref_primary_10_1097_OI9_0000000000000335
crossref_primary_10_1186_s13018_024_04835_4
crossref_primary_10_1097_PXR_0000000000000327
crossref_primary_10_2106_JBJS_23_01482
ContentType Journal Article
DBID CGR
CUY
CVF
ECM
EIF
NPM
DOI 10.1177/10711007221128562
DatabaseName Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
DatabaseTitle MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
DatabaseTitleList MEDLINE
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: EIF
  name: MEDLINE
  url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search
  sourceTypes: Index Database
DeliveryMethod no_fulltext_linktorsrc
EISSN 1944-7876
ExternalDocumentID 36373545
Genre Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Journal Article
Observational Study
GroupedDBID ---
-TM
.55
.GJ
01A
0R~
1KJ
3EH
4.4
53G
54M
5GY
5RE
6PF
AABMB
AABOD
AACKU
AACMV
AACTG
AADUE
AAEWN
AAGGD
AAGMC
AAJIQ
AAJOX
AAKGS
AAMGE
AANSI
AAPEO
AAQOH
AAQQT
AAQXH
AARDL
AARIX
AATAA
AATBZ
AAUAS
AAWTL
AAXOT
AAYTG
AAZBJ
ABAWP
ABCCA
ABDWY
ABEIX
ABFWQ
ABHKI
ABJNI
ABKRH
ABLUO
ABPGX
ABPNF
ABQKF
ABQXT
ABRHV
ABVFX
ABYTW
ACARO
ACDSZ
ACDXX
ACFEJ
ACFMA
ACFYK
ACGBL
ACGFO
ACGFS
ACGZU
ACJER
ACJTF
ACLFY
ACLHI
ACLZU
ACOFE
ACOXC
ACROE
ACSIQ
ACTQU
ACUAV
ACUIR
ACXKE
ACXMB
ADBBV
ADEIA
ADMPF
ADNBR
ADRRZ
ADTBJ
ADUKL
ADZZY
AECGH
AECVZ
AEDTQ
AEFTW
AEKYL
AENEX
AEPTA
AEQLS
AERKM
AESZF
AEUHG
AEUIJ
AEWDL
AEWHI
AEXFG
AEXNY
AFEET
AFKBI
AFKRG
AFMOU
AFQAA
AFUIA
AFXQA
AGKLV
AGNHF
AGWFA
AHJOV
AIGRN
AIIQI
AIOMO
AJABX
AJEFB
AJMMQ
AJSCY
AJUZI
AJXAJ
ALKWR
ALMA_UNASSIGNED_HOLDINGS
ALTZF
AMCVQ
ANDLU
ARTOV
AUTPY
AUVAJ
AYAKG
B8M
BBRGL
BDDNI
BKIIM
BKSCU
BPACV
BSEHC
BWJAD
BYIEH
CBRKF
CDWPY
CFDXU
CGR
CORYS
CQQTX
CS3
CUTAK
CUY
CVF
DB0
DC-
DC.
DC0
DD-
DD0
DE-
DE.
DF0
DN0
DO-
DOPDO
DU5
DV7
EBS
ECM
EIF
EJD
FHBDP
GROUPED_SAGE_PREMIER_JOURNAL_COLLECTION
H13
HZ~
J8X
JCYGO
K.F
L7B
M4V
NPM
O9-
OVD
P.9
P.B
P2P
Q1R
ROL
S01
SCNPE
SFC
SHG
SJN
SPQ
SPV
TEORI
X7M
YCJ
YRY
ZONMY
ZPPRI
ZRKOI
ZSSAH
ZXP
ID FETCH-LOGICAL-c270t-683dcd96cbaa3878ce576310fe5f10c74a962f9efd7ca88c9bfcdd06c68f448f2
IngestDate Sat Sep 28 08:20:03 EDT 2024
IsPeerReviewed true
IsScholarly true
Issue 12
Keywords ankle fracture
surgery vs nonsurgery
internal fixation
Weber B
fibula fracture
randomized controlled trial
Language English
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-c270t-683dcd96cbaa3878ce576310fe5f10c74a962f9efd7ca88c9bfcdd06c68f448f2
ORCID 0000-0002-3928-7892
0000-0002-0852-8868
0000-0003-0887-7627
0000-0002-4613-2653
PMID 36373545
ParticipantIDs pubmed_primary_36373545
PublicationCentury 2000
PublicationDate 2022-12-00
PublicationDateYYYYMMDD 2022-12-01
PublicationDate_xml – month: 12
  year: 2022
  text: 2022-12-00
PublicationDecade 2020
PublicationPlace United States
PublicationPlace_xml – name: United States
PublicationTitle Foot & ankle international
PublicationTitleAlternate Foot Ankle Int
PublicationYear 2022
SSID ssj0017319
Score 2.42677
Snippet Isolated Weber B, AO (Association for the Study of Internal Fixation) type 44B ankle fractures with no fracture to the medial side are the most common type of...
SourceID pubmed
SourceType Index Database
StartPage 1517
SubjectTerms Ankle Fractures
Ankle Joint
Fibula - injuries
Fracture Fixation - methods
Fracture Fixation, Internal - methods
Humans
Treatment Outcome
Title Minimum 5-Year Follow-up Results: CROSSBAT (Combined Randomised and Observational Study of Surgery vs No Surgery for Type B Ankle Fracture Treatment)
URI https://www.ncbi.nlm.nih.gov/pubmed/36373545
Volume 43
hasFullText
inHoldings 1
isFullTextHit
isPrint
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnZ1bb9MwFICtDiS0FwTifpMfeABFQa3jJDZv7cRUQOuktpPG02Q7tlSxJtVIh8b_4F_xozi24yRUAwEvURI3VZXz9fjcfIzQS0phGk61iSmXOqYS_umCUxGDPjbSEM2Vshndo1k2PaEfTtPTweBHr2ppW8s36tu160r-R6pwD-RqV8n-g2TbL4UbcA7yhSNIGI5_JeOjVblab9dRGn-y_XgOQabV13i7sUH57Xntqt0O5seLxWS8dOnaag2OMJiYc1EWFUhYu0at0bFsY7O2OUjoM73wS6ajS9CFVXtl6xKt9xpNonH5-Vxb29fnIZahaD2EF9rtP6vaISbc51f9IGS_6OYjSM7FV-dXHbOzNqTgNh4Dm7jbAfmqWU3R1P53Ka6puLjwzRPeg_4a90MbhPTKRLRXx5zSGFRK1tfXvq1T4JL0tC9YL_n104JLTIOnaxvk5QScXsJSPwv0MNmsHSdJluRJ6ptc_nl0p1N3GNpDezmz24jMbOSoyWjloOuarPrItTvY-S376FZ4fsfDcZbO8g663bgoeOx5u4sGuryHvjesYc8ablnDDWtvcSANvwqc4Y4zDGf4F86w4wxXBjdk4csveFa1V8AZtpzhCXac4cAZbjl7fR-dHL5bHkzjZkuPWJF8WMcZSwpV8ExJIRKWM6XB3wUPw-jUjIYqp4JnxHBtilwJxhSXRhXFMFMZM5QyQx6gG2VV6kcIKz4yEubbhDNNdSLAkAbnlxeCCHhIksfooX-LZxvft-UsvN8nvx15ivY7Dp-hmwYUhX4OVmctXzhx_gRTKYHf
link.rule.ids 780
linkProvider National Library of Medicine
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Minimum+5-Year+Follow-up+Results%3A+CROSSBAT+%28Combined+Randomised+and+Observational+Study+of+Surgery+vs+No+Surgery+for+Type+B+Ankle+Fracture+Treatment%29&rft.jtitle=Foot+%26+ankle+international&rft.au=O%27Keefe%2C+Ryan&rft.au=Naylor%2C+Justine+M&rft.au=Symes%2C+Michael+J&rft.au=Harris%2C+Ian+A&rft.date=2022-12-01&rft.eissn=1944-7876&rft.volume=43&rft.issue=12&rft.spage=1517&rft_id=info:doi/10.1177%2F10711007221128562&rft_id=info%3Apmid%2F36373545&rft_id=info%3Apmid%2F36373545&rft.externalDocID=36373545