Background: The aim of this study was to assess the prospective, longitudinal outcome after arthroscopically assisted open reduction and internal fixation (AORIF) and to compare the results with open reduction and internal fixation (ORIF) in complex ankle fractures. Methods: Acute, closed, bimalleolar equivalent, bimalleolar, or trimalleolar ankle fractures were included. The AORIF cohort was enrolled prospectively. The ORIF group was identified from a retrospective database. The same inclusion and exclusion criteria were applied. The only difference was the additional arthroscopy in the AORIF cohort. The patient-reported outcome measurement (PROM) following AORIF was assessed at 1 and 4 years of follow-up using the Olerud and Molander Ankle Score (OMAS) and Tegner activity scale (TAS). The AORIF cohort was propensity score matched (nearest-neighbor matching) to the ORIF database. The OMAS and Foot and Ankle Ability Measure (FAAM) were compared between the resulting groups. Nonparametric statistics were applied; values are presented as median (interquartile range). Twenty-six AORIF patients had a prospective 4-year follow-up. Results: No significant differences (1 year vs 4 years) were identified for the OMAS (90 [10] vs 90 [11]) and TAS (4 [2] vs 5 [2]). The severity of the cartilage lesions (International Cartilage Repair Society [ICRS] grade <4 vs ICRS of 4) had no significant influence on the PROMs. Twenty-five patients per cohort (AORIF vs ORIF) were matched. The OMAS (90 [13] vs 75 [40]; P = .008) and FAAM Activities of Daily Living (ADL; 96 [11] vs 88 [30]; P = .034) revealed significantly better outcomes for AORIF. More patients in the AORIF cohort returned to sport (96% vs 77%; P = .035), with a higher FAAM Sports score (88 [37] vs 56 [47]; P = .008). Conclusion: AORIF for complex ankle fractures led to consistently good to excellent results. The propensity score–matched analysis revealed a significantly better outcome 4 years after surgery for AORIF compared with ORIF. Level of Evidence: Level III, retrospective comparative study.

Especially after complex ankle fractures, patients regularly suffer from residual symptoms, presumably due to occult intra-articular injuries. The aim of this study was to evaluate the intra-articular lesions, identify fractures specifically at risk for these, and assess the results after arthroscopically assisted open reduction and internal fixation of complex ankle fractures after 1 year. The primary outcome was the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot score. Secondary outcome parameters were the Olerud and Molander Ankle Score (OMAS), Tegner activity scale, arthroscopic findings, functional assessment, and complications. Thirty-two patients (56% female) were enrolled. Chondral lesions were detected in 91%. Full-thickness lesions treated by microfracturing were observed in 0% of unimalleolar, 43% of bimalleolar, and 40% of trimalleolar fractures. After 1 year, the median (interquartile range) AOFAS was 94 (9) and OMAS was 90 (10) for all patients. When analyzing factors possibly influencing the outcome, age, sex, smoking, grading for surgical procedures according to the American Society of Anesthesiologists, fracture type (uni-, bi-, or trimalleolar), severity of chondral lesions graded according to the International Cartilage Repair Society (grade <4 versus grade 4), and syndesmotic instability had no significant influence on the outcome. The only variable significantly influencing the AOFAS (p = .004) and OMAS (p < .001) was body mass index (BMI; rs = -0.522 and -0.606, respectively), with a higher BMI resulting in inferior outcome scores. Complications were observed in 3 patients, 2 with superficial skin necrosis at the posterolateral incision and 1 nonunion of the medial malleolus. Taken together, these data show that intra-articular injuries were common in ankle fractures. Bi- and trimalleolar fractures were particularly at risk for full-thickness lesions. A higher BMI tended to result in inferior outcome scores. Arthroscopically assisted open reduction and internal fixation led to good to excellent results in all but 1 patient.

Purpose - The purpose of this paper is to test the theoretical proposition, put forward by Yukl et al. (2002), that the leadership constructs of transformational and transactional leadership, laissez-faire, consideration, and initiating structure can be arranged into three meta-categories of leadership, namely, relations, task, and change-oriented leadership.Design/methodology/approach - After a comprehensive literature search, 1,402 correlations from 286 sources were obtained which referred to the above mentioned leadership constructs and outcome criteria of effective leadership.Findings - It was found that three meta-categories of leadership (i.e. relations, task, and change-oriented leadership) were sufficient to explain the leadership constructs of transformational and transactional leadership, laissez-faire, consideration, and initiating structure. Moreover, it was also found that change-oriented leadership was most effective in predicting the job satisfaction of followers. In contrast, relations-oriented leadership accounted for most of the variance in both commitment and job performance.Research limitations/implications - In combination, these results allow for a more comprehensive, integrative description of effective leadership behavior.Practical implications - The results have implications for leadership assessment and development as well as leader selection and feedback.Originality/value - Applying Occam's razor, and in contrast to the majority of prior leadership studies, the present meta-analytical study provided evidence that three categories of leadership behaviors allow for a precise and comprehensive description of effective leadership behavior.

BACKGROUND:Symptomatic extensor tendon irritation is a frequent complication in volar plate osteosynthesis of distal radius fractures. It is typically caused by dorsal screw protrusion and overdrilling of the dorsal cortex. The use of self-drilling locking screws (SDLS) could overcome both causes. The practical applicability of SDLS depends on two prerequisites: (1) the feasibility of preoperative distal screw length determination, and (2) sufficient primary biomechanical stability of SDLS compared to standard locking screws (SLS). METHODS:We first assessed the feasibility of preoperative screw length determination (1): Distal radius width, depth and distal screw lengths were measured in 38 human radii. Correlations between distal radius width and depth were assessed, a cluster analysis (Ward's method and squared Euclidean distance) for distal radius width conducted, and intra-cluster screw lengths analyzed (ANOVA). The biomechanical performance of SDLS (2) was assessed by comparison to SLS in a distal radius fracture model (AO-23 A3). 75 % distal screw length was chosen for both groups to simulate a worst-case scenario. Uniaxial compression tests were conducted to measure stiffness, elastic limit, maximum force and residual tilt. Statistics comprised of independent sample t-tests and a Bonferroni correction (p < 0.0125). RESULTS:(1) Distal radius width and depth showed a high correlation (R (2) = 0.79; p < 0.001). Three distal radius width clusters could be identified: small <34 mm; medium 34-36.9 mm; large >36.9 mm. ANOVA and Tukey post-hoc analysis revealed significantly different volar-dorsal depths (p < 0.05) for nearly all screws. (2) To assess biomechanical stability nine specimens were tested each; no significant differences were found between the SDLS and SLS groups. CONCLUSIONS:This feasibility study demonstrates that (1) distal radius width can be used as a predictor for distal screw length and (2) that SDLS provides mechanical stability equivalent to SLS. These results highlight the feasibility of applying SDLS screws in volar plate osteosynthesis at least in extraarticular fractures.

Impaired ankle dorsiflexion (ADF) is known to increase forefoot pressure, which is associated to various pathologies affecting the foot and ankle. M. gastrocnemius tightness (MGT) is its most common cause. Up to date we are missing a standardized examination procedure, norm values, and a valid decision pathway to diagnose impaired ADF and MGT. The aim of this study was to define norm values for ADF using a standardized examination procedure. These were used to define a decision pathway to diagnose impaired ADF and MGT.

Purpose – The purpose of this paper is to provide a comprehensive examination of different leadership constructs investigated extensively, namely transformational and transactional leadership, laissez-faire, consideration, and initiating structure, as well as leader-member-exchange. The theoretical overlap as well as the empirical correlations between these constructs is explored. Design/methodology/approach – Overall, 735 correlations were analyzed to generate a meta-analytical correlation matrix. Findings – The meta-analyses revealed highly interrelated leadership constructs (0.26<∣ ρ ∣<0.74). Results of confirmatory factor analyses suggest a one factor solution of leadership. Research limitations/implications – The uniqueness and construct validity of leadership constructs is challenged, calling for a revision of the respective leadership theories. Ultimately, an integrative theory of leadership should be developed which accounts for similarities as well as differences between leadership constructs. An integrated theory of leadership would help: researchers to combine their forces and, consequently, organizations across the globe to better select and develop leaders for the future. Practical implications – By taking a critical, cross-theoretical compare and contrast approach, the present study yielded a comprehensive picture of the interrelationship and partial redundancy of several of the currently researched leadership constructs. Originality/value – New insights into the overlap between leadership constructs were generated and confirmed by meta-analyses.

Recent theoretical and empirical research focused on the role of affect in the process of leadership. It was proposed that followers’ interpersonal affect toward their supervisor biases the assessment of transformational leadership. In order to extend this work, the present study focused on other important, additional leadership constructs (i.e. transactional, laissez-faire, consideration, initiating structure, leader–member exchange, and ethical leadership). Utilizing data from eight empirical studies (total sample size N = 2213), it was found that liking considerably impacted the assessment of all of these leadership constructs. In addition, the convergence between these leadership constructs was biased by liking. Overall, the role of liking in the leadership process was highlighted.

As an integrative research effort, the present study critically analyzed the relative importance of six leadership constructs—(1) transformational, (2) transactional, (3) laissez‐faire, (4) consideration, (5) initiating structure, and (6) leader‐member exchange (LMX)—as predicting indicators of leadership effectiveness in the for‐profit versus the nonprofit sector. Based on data from seven samples from the for‐profit and nonprofit sectors, the unique effects of the six leadership constructs were tested on three criteria of leadership effectiveness on the individual level: job satisfaction, affective commitment, and perceived job performance. The results for the for‐profit samples revealed that LMX was the most important aspect for explaining variance in job satisfaction, and initiating structure was most important for commitment. In the nonprofit samples, LMX was the most important aspect of job satisfaction and transformational leadership for commitment. In both for‐profit and nonprofit organizations, initiating structure had the strongest unique impact on perceived job performance. We discuss implications for current leadership research and practical implications.

PurposeThe aim of this study is to contribute to the construct validity of leadership styles. Although several theories of leadership emerged in the past decades, integrative research on leadership constructs is rare. Thus, for the first time, the present study critically tests whether the leadership constructs of transformational and transactional leadership, consideration and initiating structure, and leader‐member‐exchange are convergent, or whether they exhibit discriminant validities, as hypothesized by theory.Design/methodology/approachApplying hierarchical structural equation modeling to the multitrait‐multimethod (MTMM) approach, the present study explored the convergent and discriminant validity of leadership constructs based on data from multiple sources. Altogether,N=148 dyads of leaders and subordinates from various industries in Germany participated in the present study.FindingsResults demonstrated evidence for the convergence of the leadership constructs.Practical implicationsIn leadership feedback projects in organizations, practitioners should utilize multiple rating perspectives for adequate descriptions of leadership behaviors.Originality/valueInterestingly, approximately the same amount of variance in the data was due to the rating sources as it was to the leadership constructs, suggesting strong method effects in leadership research. The present study was among the first MTMM approaches that addressed the construct validity of several leadership constructs simultaneously and thus, allows new insight into the overall network of leadership theories.

Abstract Mehrere aktuell diskutierte Theorien erfolgreicher Führung werden gegenwärtig hinsichtlich kontextualer Einschränkungen kritisch hinterfragt und aufgrund empirischer Ergebnisse präzisiert. Jedoch erfolgt diese kontextfokussierte Forschung selten theoriegeleitet, da in der Führungsforschung bislang kein einheitliches System von Dimensionen der Organisationsstruktur zu finden ist. Der vorliegende Beitrag versucht diese Lücke zu schließen, indem eine Taxonomie von organisationalen Strukturdimensionen kritisch geprüft wird. Die definierten Strukturdimensionen ergeben sich aus einer kritischen Diskussion aktueller, vor allem betriebswirtschaftlicher Literatur. Die Strukturdimensionen lassen sich als Kontextbedingungen effektiver Führung verstehen und bieten daher die Möglichkeit, Fortschritte für die Führungsforschung zu ermöglichen.

The well known constructs of transformational and transactional leadership are still facing problems concerning their discriminant validity as substantive correlations have frequently been observed between them. Nine samples, including 178 supervisors and their 834 followers, completed the German version of the Transformational Leadership Inventory (TLI). Self-ratings and aggregated observer ratings were analyzed using a SEM-based multitrait-multimethod (MTMM) approach. First, the factorial structure was confirmed for both rating perspectives and across them. In the MTMM analysis, controlling for the method effects reduced the correlations between leadership constructs from a high to a small resp. medium level and the leadership scales can be discriminated. Facilitating the use of the TLI in practical issues, norms are provided for self and observer ratings.

Ziel des vorliegenden Beitrages ist, die Gütekriterien eines Instruments zur Erfassung von ethischer Führung zu überprüfen. Ausgangspunkt war die Übersetzung der Ethical Leadership Scale von Brown, Trevino und Harrison (2005) ins Deutsche (ELS-D). Anschließend wurde anhand dreier Stichproben (N1 = 100, N2 = 119, N3 = 507) die faktorielle Binnenstruktur des Instrumentes überprüft. Es ergaben sich zwei Faktoren (ethische Mitarbeiterführung und ethisches Rollenmodell). Es zeigten sich konvergente Validitäten zwischen den Skalen ethischer Führung und transformationaler, transaktionaler, mitarbeiter- und aufgabenorientierter Führung (positive Korrelationen) sowie Laissez-faire (negative Korrelation). Demgegenüber waren die Skalen ethischer Führung erwartungskonform überwiegend unabhängig vom Alter der geführten Mitarbeiter und vom Geschlecht der Führungskraft. Hohe Zusammenhänge zwischen ethischer Führung und der Arbeitszufriedenheit sowie dem Commitment der Mitarbeiter werden als Belege für die Konstruktvalidität gewertet. Die interne Konsistenz der ELS-D-Skalen war in allen drei empirischen Studien gut. Insgesamt steht mit der hier vorgestellten deutschen Adaptation der ELS ein ökonomisches Instrument mit ansprechenden Gütekriterien für den Einsatz bereit.