Evidence map›Paper›PMID 30143808›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2020

Outcomes after unstable pertrochanteric femur fracture: intermediate versus long cephalomedullary nails.

Sorawut Thamyongkit, James S MacKenzie, Norachart Sirisreetreerux, Babar Shafiq, Erik A Hasenboehler

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Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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0cells of the map it votes in
5citing papers in PubMed
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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

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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

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Comparison of Short, Intermediate, and Long Cephalomedullary Nail Length Outcomes in Elderly Intertrochanteric Femur Fractures.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2022
    Article
  4. Focus on proximal femur fractures: surgical options and outcome.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2020
    Article
  5. Article
4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Sorawut ThamyongkitDepartment of Orthopaedic Surgery, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., #A667, Baltimore, MD, 21224-2780, USA.
James S MacKenzieDepartment of Orthopaedic Surgery, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., #A667, Baltimore, MD, 21224-2780, USA.
Norachart SirisreetreeruxDepartment of Orthopaedic Surgery, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., #A667, Baltimore, MD, 21224-2780, USA.
Babar ShafiqDepartment of Orthopaedic Surgery, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., #A667, Baltimore, MD, 21224-2780, USA.
Erik A HasenboehlerDepartment of Orthopaedic Surgery, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., #A667, Baltimore, MD, 21224-2780, USA. ehasenb1@jhmi.edu.ORCID http://orcid.org/0000-0003-1707-0008

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeOptimal cephalomedullary nail (CMN) length for unstable pertrochanteric femur fractures is controversial. Long CMNs (L-CMNs) are currently recommended; however, intermediate-length CMNs (I-CMNs) may provide stable fixation without the additional surgical steps required by L-CMNs. We analyzed outcomes after unstable pertrochanteric femur fractures treated with L-CMNs or I-CMNs to determine whether functional outcomes, perioperative measures, complications, and mortality and reoperation rates differ by CMN length.

methodsWe retrospectively reviewed medical records at our institution for 100 patients who received surgical treatment for pertrochanteric femur fractures from June 2014 to June 2016. Data from 43 unstable pertrochanteric femur fractures treated with L-CMNs (n = 25) or I-CMNs (n = 18) were analyzed. We evaluated operative time, fluoroscopy time, intraoperative blood loss, blood transfusions, and perioperative complications; peri-implant fracture, malunion, reoperation, and death; and neck-shaft angle, tip-apex distance, and 6-month postoperative functional scores. We analyzed categorical data with Fisher exact tests and continuous data with Student t tests. P < 0.05 was considered significant.

resultsThe I-CMN group had shorter operative time (68 versus 92 min; P = 0.048), shorter fluoroscopy time (72 versus 110 s; P = 0.019), and less intraoperative blood loss (80 versus 168 mL; P < 0.001) than the L-CMN group. The groups were similar in rates of blood transfusion, perioperative complications, peri-implant fracture, malunion, reoperation, and death. Six-month postoperative functional scores were similar between groups (P > 0.05).

conclusionsWe found operative advantages of I-CMNs over L-CMNs with no difference in treatment outcomes. LEVEL OF EVIDENCE: Level IV, Retrospective case series study.

Indexed as

Bone NailsAgedAged, 80 and overBlood Loss, SurgicalBlood TransfusionFemaleFemoral FracturesFluoroscopyFracture Fixation, IntramedullaryHumansMaleOperative TimePostoperative ComplicationsProsthesis DesignProsthesis FailureReoperationBlood lossFracture patternOptimal cephalomedullary nailPertrochanteric femur fracture

Identifiers

PMID30143808

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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.