Evidence map›Paper›PMID 30094560›Full record

ArticleArchives of orthopaedic and trauma surgery2018

Bone density correlates with clinical outcomes after ankle fracture fixation.

Stephen J Warner, Matthew R Garner, Peter D Fabricant, Dean G Lorich

Abstract read
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In one paragraph

Article in Archives of orthopaedic and trauma surgery, 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
1.8field-weighted citation impact, top 15% 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, 25 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Biomechanics of Osteoporotic Fracture Fixation.Current osteoporosis reports · 2019
    Review
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

4 authors at 4 institutions in 1 country.

Stephen J WarnerOrthopaedic Trauma Service, University of Texas Health Science Center at Houston, Houston, TX, USA. stephen.j.warner@uth.tmc.edu.
Matthew R GarnerOrthopaedic Trauma Service, Pennsylvania State University, Hershey, PA, USA.
Peter D FabricantPediatric Orthopaedic Service, Hospital for Special Surgery, New York, NY, USA.
Dean G LorichOrthopaedic Trauma Service, Hospital for Special Surgery and Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA.
Hospital for Special Surgery · USNew York Hospital Queens · USPenn State Milton S. Hershey Medical Center · USThe University of Texas Health Science Center at Houston · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOsteoporosis and decreased bone density are known to increase fracture incidence and severity. Although much is known regarding the effects of bone density on fracture risk and the treatment options for prevention of fragility fractures, whether bone quality alters clinical outcomes after fracture fixation is unknown. The purpose of this study was to determine whether bone quality correlates with clinical outcomes after fracture fixation. MATERIALS AND

methodsA prospective database of all operatively treated ankle fractures by a single surgeon from 2003 to 2013 was used to identify patients. All patients included in the study had preoperative computed tomography (CT) imaging of the injured ankle and postoperative CT imaging of the contralateral ankle. Hounsfield unit (HU) measurement values were determined by placing an elliptical region of interest confined to the cancellous metaphyseal region of the distal tibia and fibula. The primary and secondary clinical outcomes included Foot and Ankle Outcome Scores (FAOS) and ankle range of motion (ROM). Included patients had at least 12 months of clinical outcome data.

resultsSixty-four patients met the inclusion criteria. Comparison of HU values from the injured and contralateral side demonstrated almost perfect agreement (ICC(2,1) = 0.938), suggesting that HU values can be accurately measured in the setting of a fracture. Increased HU values of the injured distal tibia and fibula significantly correlated with improved outcomes in four of five FAOS domains, including pain, activities of daily living, sports, and quality of life (beta = 0.285-0.344; P ≤ 0.05 for all). Range of motion outcomes did not significantly correlate with HU values.

conclusionsOur results suggest that decreased bone quality, as measured using preoperative CT, significantly correlates with inferior short-term clinical outcomes. These results have significant implications for integrating bone quality into treatment algorithms for fracture patients.

Indexed as

Absorptiometry, PhotonActivities of Daily LivingAdolescentAdultAgedAged, 80 and overAnkle FracturesAnkle JointBone DensityFemaleFibulaFracture Fixation, InternalHumansMaleMiddle AgedOsteoporosisAnkle fractureBone densityCTHounsfield unitsOutcomes

Identifiers

PMID30094560
OpenAlexW2886032835

What OpenQuestion holds

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Read underepoch 390

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.