ArticleArchives of orthopaedic and trauma surgery2015
Fracture reduction with positive medial cortical support: a key element in stability reconstruction for the unstable pertrochanteric hip fractures.
Article in Archives of orthopaedic and trauma surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 159 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Pertrochanteric Fracture Fixation In Elderly Adults Using Proximal Femoral Nail Anti-rotation (HERACLES) With a T-shaped Parallel Blade: A New Design
Robot-Assisted Closed Reduction and Internal Fixation for Intertrochanteric Femoral Fractures: A Randomized Controlled Trial
Who cites it
159 citing papers in PubMed, 1 synthesis or guideline pooled it, 253 citations in OpenAlex.
- Rehabilitation protocols in unstable trochanteric fractures treated with cephalomedullary nails in elderly: current practices and outcome.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2020Pooled it
- Gamma 3 vs Gamma 3 RC in Unstable Extracapsular Hip Fractures: A Prospective Randomized study.International orthopaedics · 2026Trial
- [Application of precise-guided temporary fixation assistive devices in proximal femoral nail antirotation fixation for femoral intertrochanteric fractures].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025Trial
- Comparative analysis of radiological outcomes among cephalomedullary nails: helical, screw and winged screw.PeerJ · 2024Trial
- [Feasibility study of Kirschner wire-fixation-cortical bone technique in treatment of intertrochanteric fracture].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2019Trial
- Intramedullary Femoral Nailing-Blade Versus Screw: A Risk Analysis of Implant-Related Complications in Trochanteric Femoral Fractures.Journal of clinical medicine · 2026Article
- Association of Long Versus Standard-Length Cephalomedullary Nail Constructs with Posterior Sagging in Intertrochanteric Fractures with Posteromedial Comminution: A Retrospective Comparative Study.Journal of clinical medicine · 2026Article
- Internal-locking intramedullary nails (talons, claws, wings, wedge-locks, endopins): a mechanics-guided scoping review of designs, failure signatures, and technique imperatives.BMC musculoskeletal disorders · 2026Article
- From classification to anteromedial cortical contact: an integrative review of the Japanese and international literature on trochanteric fracture reduction and fixation.International orthopaedics · 2026Review
- Observational
- Lateral Femoral Neck and Peritrochanteric Fractures: Anatomical Classifications and Pre-Operative Reduction Techniques-A Narrative Review.Journal of functional morphology and kinesiology · 2026Review
- Atraumatic anterior hip dislocation after cephalomedullary nailing for an intertrochanteric femoral fracture: a case report highlighting the importance of initial reduction and prevention of excessive telescoping.BMC musculoskeletal disorders · 2026Article
- Comparison of the predictive performance of Chang and Baumgaertner reduction quality criteria for cutout complication in geriatric unstable intertrochanteric femur fractures.BMC musculoskeletal disorders · 2026Article
- Cephalomedullary nailing of trochanteric fractures in geriatric patients restores natural hip geometry - a retrospective radiological analysis.BMC musculoskeletal disorders · 2026Article
- Cortical Support in Unstable Intertrochanteric Fracture without Fixation of Posteromedial Fragment.Clinics in orthopedic surgery · 2026Article
- Lateral decubitus positioning was associated with improved efficiency and functional outcome compared with traction table positioning for cephalomedullary nailing of subtrochanteric femur fractures: a retrospective comparative study.BMC musculoskeletal disorders · 2026Article
- The Impact of Medial Cortical Reduction on the Outcomes of Fixation in Unstable Intertrochanteric Fractures.Journal of orthopaedic case reports · 2026Review
- [Positive cortical support reduction in treatment of trochanteric femur fractures: history in theory establishment and its inspiration for clinical innovations].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Review
- Evaluating polymethylmethacrylate (PMMA) augmentation in cephalomedullary nail fixation of hip fractures: a step towards evidence-based patient selection criteria.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Anteromedial cortical support in intertrochanteric fractures: radiographic and clinical validation in a Latin American cohort.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
99 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo introduce the concept of fracture reduction with positive medial cortical support and its clinical and radiological correlation in geriatric unstable pertrochanteric fractures.
methodsA retrospective analysis of 127 patients (32 men and 95 women, with mean age 78.7 years) with AO/OTA 31A2.2 and 2.3 hip fractures treated with cephalomedullary nail (PFNA-II or Gamma-3) between July 2010 and June 2013 was performed. They were classified into three groups according the grade of medial cortical support in postoperative fracture reduction (positive, neutral, and negative). The positive cortex support was defined that the medial cortex of the head-neck fragment displaced and located a little bit superomedially to the medial cortex of the shaft. If the neck cortex is located laterally to the shaft, it is negative with no cortical buttress, and if the two cortices contact smoothly, it is in neutral position. The demographic baseline, postoperative radiographic femoral neck-shaft angle and neck length, rehabilitation progress and functional recovery scores of each group were recorded and compared.
resultsThere were 89 cases (70 %) in positive, 26 in neutral, and 12 in negative support. No statistical differences were found between the three groups among patient age, sex ratio, prefracture score of activity of daily living, walking ability score, ASA physical risk score, number of medical comorbidities, osteoporosis Singh index, fracture reduction quality (Garden alignments), and the position of lag screw or helical blade in femoral head (TAD). In follow-up, patients in positive medial cortical support reduction group had the least loss in neck-shaft angle and neck length, and got ground-walking much earlier than negative reduction group, with good functional outcomes and less hip-thigh pain presence.
conclusionFracture reduction with nonanatomic positive medial cortical support allows limited sliding of the head-neck fragment to contact with the femur shaft and achieve secondary stability, providing a good mechanical environment for fracture healing.
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Registered trials
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.