PONE-D-24-02565Syndesmotic fixation in Weber B ankle fractures: a systematic reviewPLOS ONE

Dear Dr. Lim,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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ACADEMIC EDITOR: Minor Review

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Raffaele Vitiello

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: I read with particular interest your study aimed at evaluating the current literature on syndesmotic fixation in Weber type B fractures, assessing outcomes and complications of syndesmotic fixation, and evaluating the necessity of syndesmotic fixation in Weber type B fractures. The abstract provides a clear overview of the study's objectives, methods, and main conclusions. The introduction provides a general framework of Weber type B ankle fractures and their management, identifying syndesmotic fixation as a crucial aspect. However, a clear rationale for conducting the systematic review in this specific area is not provided. A more thorough justification would be advantageous to establish the need and relevance of the study. The Materials and Methods section describes in detail the inclusion criteria, search strategy, and approach to assessing study quality. However, a more detailed explanation of the methods used for data analysis from included studies would be beneficial. Additionally, it is not mentioned whether a study selection process was independently conducted by multiple reviewers, which could influence the validity of the results. Discussion of limitations of the included studies is limited. It would be helpful to identify any sources of bias or confounding factors that could affect the results and their interpretation. The discussion section does not exhaustively address the limitations of the study, such as potential heterogeneity among included studies and variability in syndesmotic fixation techniques. Clarifying why this specific systematic review was conducted and why it is relevant to the scientific community would be helpful. A more detailed description of the methods used to analyze data extracted from included studies could improve the transparency and validity of the study. Study limitations, such as potential heterogeneity among included studies and variability in syndesmotic fixation techniques, should be discussed in more detail. Greater attention to these points could improve the completeness and robustness of the study, thereby contributing to better understanding and application of its results.

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Reviewer #1: Yes: Giuseppe Basile

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Syndesmotic fixation in Weber B ankle fractures: a systematic review

PONE-D-24-02565R1

Dear Dr. Lim,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Raffaele Vitiello

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Dear Authors, I have read your additions, finding them entirely consistent and in accordance with my expectations. I consider your work interesting. The purpose is clear and respected. I believe that the information provided is to be considered entirely sufficient and represents useful elements to encourage the development of new scientific work.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Giuseppe Basile

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