Evidence map›Paper›PMID 28755132›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2018

Two-stage treatment in patients with patients with high-energy femoral fractures does not lead to an increase in deep infectious complications: a propensity score analysis.

S A Dingemans, M A T Sier, R W Peters, J C Goslings, T Schepers

Open access · hybridAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.2field-weighted citation impact, top 44% 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

4 citing papers in PubMed, 13 citations in OpenAlex.

  1. Article
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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 at 1 institution in 1 country.

S A DingemansTrauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
M A T SierTrauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
R W PetersTrauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
J C GoslingsTrauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
T SchepersTrauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. t.schepers@amc.nl.
Academic Medical Center · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn patients following severe trauma sometimes the physiological condition or soft tissue status may not allow definitive fixation of a femoral fracture. In these patients, an external fixator can be placed to temporarily stabilise the fracture, after which definitive fixation can be performed in a second procedure. The aim of this study was to compare the postoperative wound infection and union rates of patients treated with direct intramedullary nailing (IMN) and patients treated with the 'two-stage treatment'.

methodsAll patients with high-energy femoral fractures treated with IMN between 2000 and 2016 in a single Level 1 trauma centre were eligible. Electronic charts were reviewed for patient and surgical characteristics; furthermore, the development of complications was noted. A propensity score analysis was performed to assess the attributed risk of the external fixator on the development of postoperative wound infections.

resultsA total of 149 patients were included in this study; 93 underwent direct IMN and 56 underwent the two-stage treatment. Patients who underwent two-stage treatment were more severely injured, reflected by lower EMV and higher ISS on admission. Patients in the two-stage treatment group had a significant higher risk of postoperative wound infections (OR: 4.698, 95% CI: 1.203-18.339) but not a higher risk on deep postoperative wound infections (OR 2.345, 95% CI: 0.439-12.540). Union rate did not differ between the two groups (94% vs 94% NS).

conclusionsThe two-stage treatment is a safe treatment option in patients with a high-energy femoral fracture in terms of postoperative wound infections. Union rates are also comparable between the two treatment groups.

Indexed as

ReoperationAdultFemaleFemoral FracturesFracture Fixation, IntramedullaryFracture HealingHumansMaleNetherlandsPropensity ScoreRetrospective StudiesRisk FactorsSurgical Wound InfectionTime FactorsTrauma CentersTreatment OutcomeExternal fixatorFemoral fractureIntramedullary nailingPropensity score analysis

Identifiers

PMID28755132
PMCPMC5808064
OpenAlexW2740668657

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LicenceCC BY
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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.