Evidence map›Paper›PMID 25960644›Full record

SynthesisClinical interventions in aging2015

Intramedullary versus extramedullary fixation in the management of subtrochanteric femur fractures: a meta-analysis.

Pengcheng Liu, Xing Wu, Hui Shi, Run Liu, Hexi Shu, JinPeng Gong, Yong Yang, Qi Sun, Jiezhou Wu, Xiaoyang Nie and 1 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical interventions in aging, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 3 pooled it
3.2field-weighted citation impact, top 9% 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

18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 34 citations in OpenAlex.

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  10. [Effectiveness analysis of closed or limited open reduction and intramedullary nail fixation in treatment of Seinsheimer type Ⅴ subtrochanteric fracture].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2020
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  14. [Effectiveness analysis of surgical treatment of ipsilateral femoral neck fracture and subtrochanteric fracture].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2017
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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

11 authors at 2 institutions in 1 country.

Pengcheng LiuDepartment of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, People's Republic of China ; First Clinical Medical College, Nanjing Medical University, Nanjing, People's Republic of China.
Xing WuDepartment of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, People's Republic of China.
Hui ShiDepartment of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, People's Republic of China ; First Clinical Medical College, Nanjing Medical University, Nanjing, People's Republic of China.
Run LiuDepartment of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, People's Republic of China.
Hexi ShuDepartment of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, People's Republic of China.
JinPeng GongDepartment of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, People's Republic of China.
Yong YangDepartment of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, People's Republic of China.
Qi SunDepartment of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, People's Republic of China.
Jiezhou WuDepartment of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, People's Republic of China ; First Clinical Medical College, Nanjing Medical University, Nanjing, People's Republic of China.
Xiaoyang NieDepartment of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, People's Republic of China.
Ming CaiDepartment of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, People's Republic of China.
Shanghai Tenth People's Hospital · CNTongji University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntramedullary and extramedullary fixation methods are used in the management of subtrochanteric femur fractures. However, whether intramedullary or extramedullary fixation is the primary treatment for subtrochanteric femur fractures in adults remains debatable. LEVEL OF EVIDENCE: Meta-analyses of prospective studies, level I. MATERIALS AND

methodsThe Cochrane library, Embase, Google Scholar, and PubMed databases were searched separately for all relevant studies published before January 1, 2015. No language restriction was applied. Prospective randomized controlled trials that compared intramedullary or extramedullary internal fixation to repair subtrochanteric femur fractures in adults were included. We determined intraoperative data, postoperative complications, fracture fixation complications, wound infection, hospital stay days, and final outcome measures to assess the relative effects of different internal fixation methods for the treatment of subtrochanteric femur fractures in adults.

resultsSix studies were included in our meta-analysis. The relative risks (RRs) of revision rate was 83% lower (RR, 0.17, 95% confidence interval [CI], 0.05 to 0.60; P=0.006), fixation failure rate was 64% lower (RR, 0.36, 95% CI, 0.12 to 1.08; P=0.07), non-union rate was 77% lower (RR, 0.23, 95% CI, 0.07 to 0.81; P=0.02) in the intramedullary group compared with the extramedullary group. No significant differences were found between the intramedullary group and extramedullary group for intraoperative data, postoperative complications, wound infection, hospital stay days or final outcome measures.

conclusionIn conclusion, our meta-analysis suggests that there was no significant difference in intraoperative data, postoperative complications, wound infection, hospital stay days or final outcome measures between intramedullary and extramedullary internal fixation. However, a significant decrease occurred in the rate of fracture fixation complications for patients treated with intramedullary internal fixation, especially in elderly patients. Some differences were not significant, but the treatment of elderly subtrochanteric femur fractures using intramedullary internal fixation is recommended.

Indexed as

FemurFracture Fixation, InternalFracture Fixation, IntramedullaryHip FracturesHumansIntraoperative ComplicationsLength of StayPostoperative ComplicationsProspective StudiesRandomized Controlled Trials as TopicReoperationTreatment Outcomeextramedullaryintramedullarymeta-analysissubtrochanteric femur fracturesystematic review

Identifiers

PMID25960644
PMCPMC4423507
OpenAlexW1692459500

What OpenQuestion holds

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LicenceCC BY-NC
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.