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Vasileios Lampridis Frimley Park Hospital, UK

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Nikolaos Gougoulias Frimley Park Hospital, UK

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Anthony Sakellariou Frimley Park Hospital, UK

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Introduction Management of ankle fractures has evolved over the last 10 years. As scientific (laboratory, cadaveric and clinical) research has led to better understanding of the biomechanics and patho-anatomy of the ankle, this has allowed

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Patrick Pflüger Department of Trauma Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany

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Karl-Friedrich Braun Department of Trauma Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
Department of Traumatology and Reconstructive Surgery including Department of Orthopedic Surgery, Charite Universitätsmedizin Berlin, Berlin, Germany

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Olivia Mair Department of Trauma Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany

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Chlodwig Kirchhoff Department of Trauma Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany

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Peter Biberthaler Department of Trauma Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany

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Moritz Crönlein Department of Trauma Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany

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plantarflexion. Motions in the transverse (internal/external rotation) and coronal plane (varus/valgus) are coupled with motions in the sagittal plane. 24 Epidemiology Ankle fractures are common and account for up to 10% of all bone injuries with a

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Mario Herrera-Pérez Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain
School of Medicine, Universidad de La Laguna, Tenerife, Spain

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Pablo Martín-Vélez Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain

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David González-Martín Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain
School of Medicine, Universidad de La Laguna, Tenerife, Spain

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Miguel Domínguez-Meléndez Foot and Ankle Unit, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain

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Ahmed E Galhoum Specialty Doctor Trauma and Orthopaedics, George Eliot Hospital NHS Trust, Nuneaton, UK

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Victor Valderrabano Schmerzklinik, Basel, Switzerland
University of Basel, Basel, Switzerland

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Sergio Tejero Foot and Ankle Unit, Hospital Universitario Virgen del Rocío, Sevilla, Spain
School of Medicine, Universidad de Sevilla, Sevilla, Spain

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condition of the patient. Frailty is accelerating with the aging of the population, affecting between 25 and 50% of adults aged 85 years ( 1 , 2 , 3 , 4 , 5 ), consequently, osteoporotic ankle fractures in frail patients are increasingly frequent in

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Duy Nguyen Anh Tran The International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
Department of Orthopedics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam

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Bao Tu Thai Nguyen The International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
Department of Orthopedics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam

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Tan Thanh Nguyen Department of Orthopedics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam

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Yu-Pin Chen Department of Orthopedics, Taipei Municipal Wan-Fang Hospital, Taipei, Taiwan
Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

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Yi-Jie Kuo Department of Orthopedics, Taipei Municipal Wan-Fang Hospital, Taipei, Taiwan
Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

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‘tobacco’ in conjunction with ‘ankle fracture’, ‘foot fracture’, or ‘calcaneus fracture’, and ‘infection’ or ‘SSI’. No time or language restrictions were applied, and studies published through April 2023 were candidates for inclusion. Screening of titles

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Mehnoor Khaliq Leeds Orthopaedic & Trauma Sciences, School of Medicine, University of Leeds, Leeds, England

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Vasileios P Giannoudis Leeds Orthopaedic & Trauma Sciences, School of Medicine, University of Leeds, Leeds, England

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Jeya Palan Leeds Teaching Hospitals NHS Trust, Leeds, England

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Hemant G Pandit Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, England

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Bernard H van Duren Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, England

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 Treated ankle fractures 2-6.6 weeks  Cast immobilisation Conflicting evidence – avoid driving if right side casted versus no recommendations given Upper limb  Cast immobilisation of left arm Avoid driving while casted  Splints

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Holger Keil BG Trauma Center Ludwigshafen, Germany

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Nils Beisemann BG Trauma Center Ludwigshafen, Germany

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Benedict Swartman BG Trauma Center Ludwigshafen, Germany

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Sven Yves Vetter BG Trauma Center Ludwigshafen, Germany

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Paul Alfred Grützner BG Trauma Center Ludwigshafen, Germany

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Jochen Franke BG Trauma Center Ludwigshafen, Germany

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joint space must be visible completely. An important issue when treating ankle fractures is to determine syndesmotic injuries. After completion of the osteosynthesis of the distal fibula, the stability of the syndesmosis is tested with constant

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