Trial reportBMC musculoskeletal disorders2016
Comparison of intramedullary and extramedullary fixation of stable intertrochanteric fractures in the elderly: a prospective randomised controlled trial exploring hidden perioperative blood loss.
Trial report in BMC musculoskeletal disorders, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Surgical interventions for treating extracapsular hip fractures in older adults: a network meta-analysis.The Cochrane database of systematic reviews · 2022Pooled it
- Cephalomedullary nails versus extramedullary implants for extracapsular hip fractures in older adults.The Cochrane database of systematic reviews · 2022Pooled it
- Efficacy and safety of tranexamic acid for patients with intertrochanteric fractures treated with intramedullary fixation: A systematic review and meta-analysis of current evidence in randomized controlled trials.Frontiers in pharmacology · 2022Pooled it
- Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials.Acta orthopaedica et traumatologica turcica · 2020Pooled it
- Effects of aminocaproic acid on perioperative hidden blood loss in elderly patients with femoral intertrochanteric fracture treated with proximal femoral nail anti-rotation.The Journal of international medical research · 2019Trial
- Association of bone mineral density with perioperative hidden blood loss in older adults undergoing intramedullary nailing for unstable intertrochanteric fractures.BMC geriatrics · 2026Article
- Perioperative Anemia and Transfusion Management in Older Adults with Osteoporotic Hip Fractures: A Narrative Review of Current Evidence and Emerging Strategies.Clinical interventions in aging · 2026Review
- Review
- Evaluating Postoperative Hidden Blood Loss in Proximal Femoral Nail Anti-Rotation Fixation: The Role of Greater Trochanter Fracture Comminution.Medical science monitor : international medical journal of experimental and clinical research · 2025Article
- Plate, short nail, or long nail? Revision rates and complications of three different treatments for peritrochanteric femur fractures.Journal of orthopaedics · 2025Article
- Extra-capsular proximal femoral fractures: a cohort comparison of union and complication rates after ballistic versus blunt trauma.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Tranexamic acid: single topical application for femoral neck fractures treated with arthroplasty results in lowest blood loss.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Comparing Intramedullary Nails versus Dynamic Hip Screws in the Treatment of Intertrochanteric Hip Fractures on Post-operative Rehabilitation Outcomes - A Systematic Review and Meta-Analysis.Geriatric orthopaedic surgery & rehabilitation · 2025Review
- Efficacy and Safety of Tranexamic Acid on Hidden Blood Loss in Osteoporotic Vertebral Compression Fractures Patients Treated with Percutaneous Kyphoplasty: A Prospective Randomized Controlled Trial.Therapeutics and clinical risk management · 2024Article
- Complication Rates and Survival of Nonagenarians after Hip Hemiarthroplasty versus Proximal Femoral Nail Antirotation for Intertrochanteric Fractures: A 15-Year Retrospective Cohort Study of 113 Cases.Orthopaedic surgery · 2023Article
- Clinical observation and finite element analysis of femoral stable interlocking intramedullary nail in intertrochanteric fractures.International orthopaedics · 2023Article
- Comparison of surgical invasiveness, hidden blood loss, and clinical outcome between unilateral biportal endoscopic and minimally invasive transforaminal lumbar interbody fusion for lumbar degenerative disease: a retrospective cohort study.BMC musculoskeletal disorders · 2023Article
- Proximal femoral bionic nail (PFBN)-an innovative surgical method for unstable femoral intertrochanteric fractures.International orthopaedics · 2023Article
- Blood-Transfusion Risk Factors after Intramedullary Nailing for Extracapsular Femoral Neck Fracture in Elderly Patients.Journal of functional morphology and kinesiology · 2023Article
- Anticoagulants and fracture morphology have a significant influence on total blood loss after proximal femur fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHip fracture is a severe and common injury that occurs predominantly in the elderly. Blood loss in the perioperative period is associated with a greater risk of dying in anaemic patients. The aim of the study was to explore the best way to treat stable intertrochanteric fractures, taking hidden blood loss into account.
methodsThis prospective, randomised blinded study included patients aged over 65 years with stable intertrochanteric fractures (Evans grades I and II). The patients were allocated to one of two groups treated via extramedullary or intramedullary fixation. Patient data were retrieved from electronic charts. Functional recovery was evaluated using the Functional Recovery Score of Zuckerman. Postoperative complications were also recorded. The formula of Nadler and Gross was used to calculate blood loss.
resultsThere were 92 patients in the extramedullary and 106 in the intramedullary group. Age, sex, the cause of injury, the type of fracture, the observed blood loss, functional recovery, time to union, complications, and American Society of Anesthesiologists classification did not differ significantly between the two groups (all p-values > 0.05). The frequencies of lung infection, electrolyte imbalance, and hypoproteinemia differed between groups (all p-values < 0.05). Total and hidden blood loss were higher in the intramedullary group (p = 0.001).
conclusionExtramedullary (compared with intramedullary) fixation of stable intertrochanteric fractures significantly reduces perioperative blood loss but affords similar functional outcomes and times to union. In view of the morbidity and complications associated with acute anaemia and transfusions, extramedullary fixation may be the optimal choice for treatment of stable fractures, being associated with reduced blood loss.
trial registrationThe study was retrospectively registered at the Chinese Clinical Trial Registry, number: ChiCTR-INQ-16009754 , trial registration date: 6th Nov. 2016.
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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.