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The results must be interpreted with caution due to the low numbers of patients with these characteristics observed. Second, we did not have long-term follow-ups; so, we have not included patients who might develop osteoarthritis in the long term which would possibly need fusion. The strength of our study was that we had access to a high-quality database which was collected for the purpose of this investigation. We did not find a significant effect of timing to surgery with regard to presence of complications in our series. In the published literature, variable results have been reported with Pictilisib price regard to the timing of surgery. In a review of 202 cases, Konarth et al. [23] did not find a significant difference in complication rates and length of stay between patients who were operated within Ceritinib in vitro who were operated later than 24?h from admission. The difference between these findings is probably due to the effect of other confounding factors and relatively small sample sizes [26]. Higher complications may occur if the patient is operated too early without optimising the correctable medical co-morbidities. However, it is important to avoid delaying the procedure for too long. Larger prospective series are needed to clarify the effect of waiting time to surgery. In a series of 25 patients, Fong et al. [27] suggested that the main reason for fixation failure was incompliance with postoperative non-weight bearing. Their findings highlight the importance of close supervision during rehabilitation in these patients. Internal fixation of ankle fractures in those over 60 carries a high rate of complications and revision surgery. This should be explained whilst obtaining patient consent. Prospective studies with larger numbers and longer follow-ups are needed to further identify the factors that predict failure of ankle fracture fixation in this age group. The development of a scoring system based ARAF on logistic regression results would help predict the rate of failure in an individual patient. Further large-scale studies are needed to validate the predictive value of the suggested modified Charlson score. All authors confirm that there are no conflicts of interests. The authors would like to thank Ms. Suzie Cro for her help and supervision in performing the statistical analysis. ""There is still a debate as to which structures in the cervical spine are damaged after whiplash injury and might be the cause of pain. Facet joint injuries and disc injuries were hypothesized as typical anatomical�Cpathological findings in whiplash injuries [1], [2]?and?[3]. Bogduk et al.