SynthesisArchives of orthopaedic and trauma surgery2021
Incidence of nonunion after surgery of distal femoral fractures using contemporary fixation device: a meta-analysis.
Synthesis in Archives of orthopaedic and trauma surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05272631 (Depuy Synthes Lower Extremity Shaft Nail Registry), which is not on this map. Cited by 22 papers, 5 of them syntheses 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.
Depuy Synthes Lower Extremity Shaft Nail Registry (RFN-Advanced™ Retrograde Femoral Nailing System/ TN-Advanced™ Tibial Nailing System)
Who cites it
22 citing papers in PubMed, 5 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Which fixation produces the best outcome for distal femoral fractures? Meta-analysis and systematic review of retrograde nailing versus distal femoral plating in 2432 patients and 33 studies.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Pooled it
- Combined nail-plate constructs in the management of osteoporotic native distal femoral fractures: a systematic review of the available evidence.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Pooled it
- Interventions for treating fractures of the distal femur in adults.The Cochrane database of systematic reviews · 2022Pooled it
- Biomechanical and anatomical considerations for dual plating of distal femur fractures: a systematic literature review.Archives of orthopaedic and trauma surgery · 2022Pooled it
- Union rates and functional outcome of double plating of the femur: systematic review of the literature.Archives of orthopaedic and trauma surgery · 2022Pooled it
- Clinical outcomes and risk factors in the surgical treatment of distal femur fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Article
- Comparing Locking Compression Plate and Retrograde Nail in the management of distal femur fracture: A Comprehensive Analysis.Journal of orthopaedic case reports · 2026Article
- Article
- [Effectiveness of staged therapy using external fixation frame for infectious nonunion near knee joint].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025Article
- Application of the LEG NUI score to assess revision success in established distal femur non-unions.Journal of orthopaedics · 2025Article
- Distal femur fractures: The use of a fibular strut allograft with dual locking plates allows for early weight bearing.BioMedicine · 2025Article
- Management of Distal Femoral Non-union: A Systematic Review.Indian journal of orthopaedics · 2024Review
- Rates of interlock screw back-out are high with the retrograde femoral nailing advanced system for distal femur fractures.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- A case series utilizing bone marrow aspirate concentrate, cancellous bone autograft, platelet-rich plasma and autologous fibrin for the treatment of femur nonunions.Regenerative medicine · 2024Article
- Medial augmentation plating of aseptic distal femoral nonunions.BMC musculoskeletal disorders · 2023Article
- Outcome Evaluation of Distal Femoral Fractures Following Surgical Management: A Retrospective Cohort Study.Journal of personalized medicine · 2023Article
- Modified use of the proximal humeral internal locking system (PHILOS) plate for distal femoral nonunions.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Article
- Immediate Full Weight-Bearing Versus Partial Weight-Bearing After Plate Fixation of Distal Femur Fractures in Elderly Patients. A Randomized Controlled Trial.Geriatric orthopaedic surgery & rehabilitation · 2021Article
- Does Teriparatide Improve Fracture Union?: A Systematic Review.Journal of bone metabolism · 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
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeNonunion is the most frequent cause of reoperation and is associated with high morbidity after distal femur fracture (DFF). We examined the rates of nonunion requiring reoperation after fixation for DFF using a locking compression plate (LCP) or retrograde intramedullary nail (RIMN).
methodsWe included four studies comparing LCP and RIMN and 38 single-cohort studies reporting LCP or RIMN. In total, 2156 femurs were included and 166 non-unions were detected. We conducted a pair-wise meta-analysis (with a fixed-effects model) on the four comparative studies and a proportional meta-analysis on the 38 articles to estimate the nonunion rate. We performed sensitivity analysis by comparing studies using LCP with less invasive surgical systems (LISS) with those that used RIMN.
resultsThe pairwise meta-analysis showed a similar nonunion rate between the groups [odds ratio: 1.02; 95% confidence interval (CI) 0.94-1.11, p = 0.633]. According to proportional meta-analysis, the pooled prevalence of nonunion was 5% (95% CI 4-7) totally, 6% (95% CI 4-8) in the LCP group, and 4% (95% CI 2-6) in the RIMN group (heterogeneity: p = 0.105). According to the sensitivity analysis, there was no difference in the union rate. The pooled prevalence of nonunion from sensitivity analysis was 4 % (95% CI, 3-5); it was 4% (95% CI, 3-6) in LCP with LISS and was 4% (95% CI, 2-6) in RIMN group (heterogeneity: p = 0.941).
conclusionApproximately 5% of patients who underwent LCP or RIMN fixation developed nonunion. Therefore, LCP and RIMN are effective DFF techniques and mastering one of them is essential.
Indexed as
Identifiers
What OpenQuestion holds
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.