Evidence map›Paper›PMID 23389806›Full record

ArticleClinical orthopaedics and related research2013

Unstable intertrochanteric femur fractures: is there a consensus on definition and treatment in Germany?

Matthias Knobe, Gertraud Gradl, Andreas Ladenburger, Ivan S Tarkin, Hans-Christoph Pape

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Article in Clinical orthopaedics and related research, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 6 pooled it
4.9field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 6 syntheses or guidelines pooled it, 110 citations in OpenAlex.

  1. Pooled it
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  9. [Pertrochanteric fractures].Unfallchirurgie (Heidelberg, Germany) · 2026
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  15. Trends in Medicare Utilization and Reimbursement for Intertrochanteric Femur Fractures: A 21-Year Review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024
    Article
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  18. Complication rates after proximal femoral nailing: does level of training matter?Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Matthias KnobeDepartment of Orthopaedic Trauma, Medical Faculty, RWTH Aachen University, 30 Pauwelsstreet, 52074, Aachen, Germany. mknobe@ukaachen.de
Gertraud Gradl
Andreas Ladenburger
Ivan S Tarkin
Hans-Christoph Pape
RWTH Aachen University · DEUniversitätsklinikum Aachen · DEUniversity of Pittsburgh Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExtramedullary and intramedullary implants have improved in recent years, although consensus is lacking concerning the definition and classification of unstable intertrochanteric fractures, with uncertainties regarding treatment. QUESTIONS/PURPOSES: We conducted a national survey of practicing chairpersons of German institutions to determine current perspectives and perceptions of practice in the diagnosis, management, and surgical treatment of unstable intertrochanteric fractures.

methodsBetween January and February 2010, we emailed 575 German chairpersons of trauma and/or orthopaedic departments, asking them to complete a 26-question web-based survey regarding three broad domains: fracture classification and instability criteria, implants and surgical treatment algorithms, and timing of operations. Response rate was 42%.

resultsThere was a clear preference for use of the AO/OTA fracture classification with geographic variations. Absence of medial support was considered the main criterion for fracture instability (84%), whereas a broken lateral wall and detached greater trochanter were considered by 4% and 5% of the respondents, respectively, to determine instability. Two percent routinely fixed unstable intertrochanteric fractures with extramedullary devices. Ninety-eight percent of German hospitals reportedly perform surgery within 24 hours after admission. Time to surgery was dependent on hospital level, with more direct surgeries in Level I hospitals.

conclusionsDespite varying opinions in the literature in recent years, we found some instability criteria (lateral wall breach, a detached greater trochanter) played a minor role in defining an unstable intertrochanteric fracture pattern. Despite recent meta-analyses suggesting clinical equivalence of intra- and extramedullary implants, few respondents routinely treat unstable intertrochanteric fractures with extramedullary plates. Additional studies are required to specify the influence of fracture characteristics on complication rate and function and to establish a classification system with clear treatment recommendations for unstable intertrochanteric fractures.

Indexed as

Bone NailsBone ScrewsConsensusFemurFracture FixationGermanyHealth Care SurveysHip FracturesHip JointHumansTreatment Outcome

Identifiers

PMID23389806
PMCPMC3734428
OpenAlexW2043086007

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.