Evidence map›Paper›PMID 27722824›Full record

SynthesisInternational orthopaedics2017

Intramedullary and extramedullary fixations for the treatment of unstable femoral intertrochanteric fractures: a meta-analysis of prospective randomized controlled trials.

A-Bing Li, Wei-Jiang Zhang, Jie Wang, Wei-Jun Guo, Xin-Hua Wang, You-Ming Zhao

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in International orthopaedics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 7 pooled it
3.8field-weighted citation impact, top 7% 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

31 citing papers in PubMed, 7 syntheses or guidelines pooled it, 61 citations in OpenAlex.

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  3. 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 · 2020
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

A-Bing LiDepartment of Orthopaedics, The Second Affiliated Hospital of Wenzhou Medical University, 109# Xue Yuan Xi Road, Wenzhou, Zhejiang, 325000, China.
Wei-Jiang ZhangDepartment of Orthopaedics, The Second Affiliated Hospital of Wenzhou Medical University, 109# Xue Yuan Xi Road, Wenzhou, Zhejiang, 325000, China.
Jie WangDepartment of Cardiology, The Second Affiliated Hospital of Wenzhou Medical University, 109# Xue Yuan Xi Road, Wenzhou, Zhejiang, 325000, China.
Wei-Jun GuoDepartment of Orthopaedics, The Second Affiliated Hospital of Wenzhou Medical University, 109# Xue Yuan Xi Road, Wenzhou, Zhejiang, 325000, China.
Xin-Hua WangDepartment of Orthopaedics, The Second Affiliated Hospital of Wenzhou Medical University, 109# Xue Yuan Xi Road, Wenzhou, Zhejiang, 325000, China.
You-Ming ZhaoDepartment of Orthopaedics, The Second Affiliated Hospital of Wenzhou Medical University, 109# Xue Yuan Xi Road, Wenzhou, Zhejiang, 325000, China. wmuorthopaedic@sina.com.
Wenzhou Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIntramedullary and extramedullary fixation methods are widely used to treat unstable femoral intertrochanteric fractures, but the optimal surgical method remains controversial. The aim of this study was to estimate the outcomes of intramedullary fixation versus extramedullary fixation in treating unstable femoral intertrochanteric fractures.

methodsElectronic literature databases were used for searching including MEDLINE (Ovid interface), EMBASE (Ovid interface) and the Cochrane Central Register of Controlled Trials (CENTRAL) (Wiley Online Library) (up to March 30, 2016). Only human studies, which were designed as randomized controlled clinical trials, were included. Two authors independently evaluated the quality of original literature and extracted data from eligible literature.

resultsEleven randomized controlled trials involving 1,543 patients were included. Intramedullary fixation was significantly better in functional scores (SMD 0.43, 95 % CI 0.14-0.73, P = 0.004) and had less blood loss (SMD -0.96, 95 % CI -1.77 to -0.11, P = 0.03) in contrast with extramedullary fixation. No obvious discrepancies were found in adverse events, operative time, blood transfusion, and hospital stay between intramedullary and extramedullary fixations.

conclusionOur meta-analysis of 11 prospective randomized controlled trials suggested: no obvious discrepancies were found in adverse events, operative time, blood transfusion, and hospital stay between intramedullary and extramedullary fixations. Given the better results of intramedullary fixation in terms of functional scores and blood loss, we recommend the intramedullary fixation technique in treating unstable femoral intertrochanteric fractures. Large multi-center RCTs, which focused on unstable femoral intertrochanteric fractures, are needed to evaluate the efficiency of alternative internal fixation strategies in the future.

Indexed as

AgedAged, 80 and overBone NailsDatabases, FactualFracture FixationHip FracturesHumansLength of StayOperative TimePostoperative ComplicationsTreatment OutcomeExtramedullary fixationIntramedullary fixationMeta-analysisRandomized controlled trialsUnstable femoral intertrochanteric fractures

Identifiers

PMID27722824
OpenAlexW2528678087

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.