Evidence map›Paper›PMID 32670600›Full record

ArticlePilot and feasibility studies2020

A cohort study comparing internal fixation for undisplaced versus hip arthroplasty for displaced femoral neck fracture in the elderly: a pilot study for a clinical trial.

Sebastian Mukka, Pontus Sjöholm, Athir Aziz, Thomas Eisler, Bakir Kadum, Ferid Krupic, Per Morberg, Arkan Sayed-Noor

2 registry-linked trialsOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pilot and feasibility studies, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 23% 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.

NCT03392285 completednot on this map

Undisplaced Femoral Neck Fractures: Treatment With Internal Fixation or Hip Arthroplasty

TypeobservationalSponsorSundsvall HospitalRan2013 to 2017Enrolled235ConditionsHip Fractures, Femoral Neck Fractures, Undisplaced Fracture, Internal FixationArmsInternal fixation or hip arthroplasty
NCT06152198 narecruitingnot on this mapstarted 2021, after this paper: background citation

Internal Fixation Versus Hip Replacement in Older Adults with an Garden I/II Femoral Neck Fracture: Physical Function and Pain in Elderly Patients - a Substudy of the Hipsther Trial

TypeinterventionalSponsorUppsala UniversityRan2021 to 2027Enrolled340ConditionsHip Fractures, Femoral Neck Fractures, Undisplaced Fracture, Treatment ComplicationArmsTreatment
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
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  5. Review
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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

8 authors at 4 institutions in 1 country.

Sebastian MukkaDepartment of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
Pontus SjöholmDepartment of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
Athir AzizDepartment of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
Thomas EislerDepartment of clinical sciences at Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden.
Bakir KadumDepartment of Biomedical and Clinical Sciences (BKV), Linköping University, Linköping, Sweden.ORCID 0000-0003-4698-8627
Ferid KrupicInstitute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Per MorbergDepartment of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
Arkan Sayed-NoorDepartment of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
Umeå University · SEKarolinska Institutet · SELinköping University · SEUniversity of Gothenburg · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe literature regarding undisplaced femoral neck fractures (FNF) is sparse. The aim of this prospective feasibility study is to compare the clinical outcome after undisplaced FNF treated with internal fixation (IF) and displaced FNF treated with hip arthroplasty. We hypothesized that hip arthroplasty would give a lower incidence of reoperations.

methodsA total of 235 patients were included with a median age of 84 years (range 65-99). A consecutive series of 65 patients with undisplaced FNF were treated with IF, and 170 patients with displaced FNF were treated with either a total hip arthroplasty or a hemiarthroplasty. Follow-up interviews were conducted at 1 year using the Harris Hip Score (HHS), WOMAC, and pain numeric rating scale (PNRS). The minimum follow-up time was 22 months. There was no difference in baseline data between the groups.

resultsNineteen (8%) hips required reoperation at least once at a mean of 6 months (range 0-35). The rate of reoperation was higher in the IF group compared to the hip arthroplasty group (13.8% vs. 5.9%, 95% CI 0.9-6.4). The overall 1-year and 2-year mortality was 28% and 40%, respectively, with no difference between the groups. The most common reasons for reoperations in the IF group were non-union and avascular necrosis, and 6 patients were treated with hip or excision arthroplasty. In the arthroplasty group, the most common indications were deep infection and dislocation. We did not find any differences between the groups in terms of HHS, WOMAC, and PNRS.

conclusionsIn this feasibility study, we found no differences in patient-reported outcomes between the groups although IF required a higher rate of reoperations. Further randomized trials are needed to establish the optimal treatment of undisplaced FNF in the elderly.

trial registrationClinicalTrial.org, NCT03392285. Retrospectively registered on 5 February 2018.

Indexed as

ArthroplastyDisplacedHip fracturesInternal fixationReoperationUndisplaced

Identifiers

PMID32670600
PMCPMC7353692
OpenAlexW3042039541

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.