SynthesisMedicine2019
A meta-analysis comparing intramedullary with extramedullary fixations for unstable femoral intertrochanteric fractures.
Synthesis in Medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled 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.
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
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cephalo-medullary nailing versus dynamic hip screw with trochanteric stabilisation plate for the treatment of unstable per-trochanteric hip fractures: a meta-analysis.Journal of orthopaedic surgery and research · 2021Pooled it
- Intramedullary Nailing vs Sliding Hip Screw in Trochanteric Fracture Management: The INSITE Randomized Clinical Trial.JAMA network open · 2023Trial
- Incidence, Impact, and Complications of Short Cephalomedullary Nail Toggling in Patients with Wide Femoral Medullary Canal.Journal of clinical medicine · 2025Article
- A Novel Interfragmentary Technique vs. A Conventional Posterolateral Approach for Unstable Femoral Intertrochanteric Fractures in the Elderly: A Retrospective Cohort Study.Medicina (Kaunas, Lithuania) · 2025Article
- [Short-term effectiveness of Gamma 3 U-Blade system for osteoporotic intertrochanteric fractures in the elderly].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025Article
- Angle-Adjustable Dynamic Hip Screw Plate for Unstable Trochanteric Fractures in Middle-Aged Patients: Mid-Term Outcomes and Return to Sport.Journal of clinical medicine · 2024Article
- Locking in trochanteric fractures: a comparison of static versus dynamic locking using the Gamma3 nail.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Article
- Evaluation of quality of life and associated factors in patients with intertrochanteric femoral fracture.PloS one · 2023Article
- The Effect of Bone Morphology on Fracture Type and Treatment Result in Patients with Intertrochanteric Femur Fracture Aged over 65 year.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2022Article
- Reduction with Pre-Drilling Combined with a Finger Reduction Tool in Difficult-to-Reduce Intertrochanteric Fracture.Orthopaedic surgery · 2022Article
- Short cephalomedullary nail toggle: a closer examination.OTA international : the open access journal of orthopaedic trauma · 2022Article
- What is the importance of distal nail diameter in the treatment of intertrochanteric femur fractures?Joint diseases and related surgery · 2022Article
- Treatment of Elderly Femoral Intertrochanteric Fracture by InterTan Intramedullary Nail and PFNA.Evidence-based complementary and alternative medicine : eCAM · 2022Article
- Article
- The Cost and Consequences of Failed Osteosynthesis of Intertrochanteric Femur Fractures: A Matched Cohort Study.Indian journal of orthopaedics · 2021Article
- Procedure for Femoral Intertrochanteric Fractures using the "Three-Finger Method" Assisted by Proximal Femoral Nail Antirotation.Orthopaedic surgery · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo find out whether the intramedullary fixations are superior to the extramedullary fixations in treating unstable femoral intertrochanteric fractures (UFIFs).
methodsThe meta-analysis of randomized controlled trials (RCTs) was conducted by searching the PubMed, Cochrane Library, and Embase databases to evaluate functional scores, surgical outcomes, and adverse events in adult patients receiving intramedullary fixations in comparison to extramedullary fixations. Risk ratio (RR) or weighted mean difference (WMD)/standard mean difference (SMD) with 95% confidence intervals (CIs) were calculated as effect sizes.
resultsA total of 18 RCTs, comprising 2414 patients, were included in this meta-analysis. Primary efficacy outcome: Parker scores [weighted mean difference, 1.10, 95% confidence interval (CI), 0.64-1.55; P < .0001] and Harris hip scores [risk ratio, 1.24, 95%CI, 1.09 -1.41; P = .0008] were higher in the intramedullary fixation group. Moreover, blood loss, operative time, length of incision, hospital stay, and implant failure were superior in the intramedullary fixation group. Other secondary efficacy outcome: No significant differences were found between the 2 groups in terms of fluoroscopy time, mortality, cut-out, nonunion, superficial wound infection, later fracture, and reoperation.
conclusionsThis meta-analysis suggested that intramedullary fixation is more effective and safer than extramedullary fixation in treating UFIFs. Furthermore, blood loss, operative time, length of incision, hospital stay, and implant failure were superior in the intramedullary fixation group.
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Registered trials
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.