Evidence map›Paper›PMID 28545316›Full record

Observational studyThe journal of spinal cord medicine2018

Lower extremity fractures in patients with spinal cord injury characteristics, outcome and risk factors for non-unions.

Lukas Grassner, Barbara Klein, Doris Maier, Volker Bühren, Matthias Vogel

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The journal of spinal cord medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

28 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Beyond the initial impact: a systematic review of post-traumatic bone loss and its mechanisms.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
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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.

Lukas Grassnera Center for Spinal Cord Injuries, Trauma Center Murnau , Murnau , Germany.ORCID 0000-0002-3390-0895
Barbara Kleinb Institute of Molecular Regenerative Medicine , Paracelsus Medical University , Salzburg , Austria.
Doris Maiera Center for Spinal Cord Injuries, Trauma Center Murnau , Murnau , Germany.
Volker Bührena Center for Spinal Cord Injuries, Trauma Center Murnau , Murnau , Germany.
Matthias Vogela Center for Spinal Cord Injuries, Trauma Center Murnau , Murnau , Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

contextSublesional osteoporosis is an important sequel after spinal cord injury (SCI) resulting in a high incidence of fractures and impaired osseous healing due to altered bone metabolism. The following study aims to identify demographic characteristics and outcome of patients with SCI with lower extremity fractures.

designRetrospective observational study.

settingLevel-I cross-regional trauma center.

participantsAll patients with SCI suffering from osteoporotic/pathologic fractures during an 11-year-period (01/2003-12/2013) at the Center for Spinal Cord Injuries (Trauma Center Murnau) were analyzed via a chart review. OUTCOME MEASURES: Demographics, surgical and radiologic outcome as well as complication rate were assessed with a special emphasis on union rates and independent risk factors for non-unions.

resultsWe identified 132 patients (105 males) who fulfilled the inclusion criteria. Most of them were paraplegic (n=101) and showed motor complete syndromes (n=119). Supracondylar femur fractures were the most prevalent in this study (n=47). We observed a non-union rate of 15.9% (n=21). The development of pseudarthrosis was associated with the time interval since the initial SCI (P < 0.010), delayed in-patient submission (P < 0.038), fracture classification (P < 0.002) and the localization of the fracture (P < 0.0001). The overall complication rate was 16.7%. All dislocated subtrochanteric femur fractures (Garden III and IV) (n=10) developed a non-union, regardless of their management (conservative or surgical). The following independent predictors for non-unions were identified: fracture localization (P < 0.0002), fracture classification (P < 0.056), and fracture management (P < 0.036).

conclusionsEven though modern techniques allow surgical interventions in bones with reduced mineral density, non-unions remain a common complication in patients with SCI. Risk factors for non-unions of lower extremity fractures are identified.

Indexed as

AdultAgedFemaleFractures, MalunitedHumansLower ExtremityMaleMiddle AgedOsteoporotic FracturesSpinal Cord InjuriesComplicationNon-unionOsteoporosisOutcomeSpinal cord injury

Identifiers

PMID28545316
PMCPMC6217470

What OpenQuestion holds

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Registered trials

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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.