Evidence map›Paper›PMID 31811373›Full record

ArticleArchives of orthopaedic and trauma surgery2020

Double-plate compound osteosynthesis for pathological fractures of the proximal femur: high survivorship and low complication rate.

Sophie R Merckaert, Christian D Fontanellaz-Castiglione, Eric D Fornari, Moritz Tannast

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Article in Archives of orthopaedic and trauma surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 32% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

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4 · The record

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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 2 countries.

Sophie R MerckaertDepartment of Orthopaedic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Christian D Fontanellaz-CastiglioneDepartment of Orthopaedic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Eric D FornariPediatric Orthopedic Surgery and Sports Medicine, Albert Einstein College of Medicine, The Children's Hospital at Montefiore, Bronx, NY, USA.
Moritz TannastDepartment of Orthopaedic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. moritz.tannast@unifr.ch.
Children's Hospital at Montefiore · USUniversity Hospital of Bern · CHUniversity of Bern · CHUniversity of Fribourg · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionManagement of pathological fractures of the proximal femur is often challenging. Compound double-plate osteosynthesis has been specifically developed for surgical treatment of these pathological fractures. To our knowledge, this study represents the largest series to date of double-plate compound osteosynthesis with the longest follow-up. MATERIALS AND

methodsUsing our institutional digital database, we identified 61 procedures in 53 patients at the proximal femur. Patients were divided into two groups. A 'primary' group with all cases in which a double-plate compound osteosynthesis was performed as initial procedure (n = 46) and a 'revision' group with all cases in which a double-plate compound osteosynthesis was performed as revision procedure after failed previous attempts of internal fixation (n = 15). (1) The survivorship of the hip was calculated using the Kaplan-Meier survivorship analysis. (2) Complications were graded using Sink's classification. (3) The functional outcome was quantified with the Merle d'Aubigné and Postel score. (4) Risk factors were identified based on a multivariate Cox-regression analysis.

resultsThe cumulative Kaplan-Meier survivorship of the primary group was 96% at 6 months, 90% at 1 year, 5 years and thereafter and 83% at 6 months, 74% at 1 year, 53% at 2 years for the 'revision' group (p = 0.0008). According to the classification of Sink et al., the rate of grade III and IV complications was significantly lower in the primary group (p < 0.0001). The mean Merle d'Aubigné score was 14 ± 7 at 0-3 months, 13 ± 3 at 3-6 months, 15 ± 3 at 6-12 months and 15 ± 4 thereafter (p = 0.54). The only multivariate negative predictor was previous surgery with a hazard ratio of 9.2 (p < 0.006).

conclusionDouble-plate compound osteosynthesis is a valuable treatment option for pathological fractures in proximal femur with good functional results.

Indexed as

Fracture Fixation, InternalAdultAgedAged, 80 and overFemaleFemoral FracturesFractures, SpontaneousHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesBone metastasisCompound osteosynthesisPathological fracturesProximal femur

Identifiers

PMID31811373
OpenAlexW2993098770

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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.