Evidence map›Paper›PMID 32707017›Full record

ArticleGlobal spine journal2020

Clinical and Radiological Outcomes After Surgical Treatment of Lower Limb Fractures in Patients With Spinal Cord Injury.

Lars Ung, Malte Ohlmeier, Birger Jettkant, Dennis Grasmücke, Mirko Aach, Renate Meindl, Volkmar Nicolas, Thomas A Schildhauer, Mustafa Citak

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Global spine journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact, top 87% 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

4 citing papers in PubMed, 5 citations in OpenAlex.

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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

9 authors at 1 institution in 1 country.

Lars UngBG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany.
Malte OhlmeierBG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany.ORCID https://orcid.org/0000-0002-2421-501X
Birger JettkantBG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany.
Dennis GrasmückeBG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany.
Mirko AachBG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany.
Renate MeindlBG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany.
Volkmar NicolasBG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany.
Thomas A SchildhauerBG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany.
Mustafa CitakBG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany.
BG University Hospital Bergmannsheil Bochum · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designRetrospective observational study.

objectivesTo analyze the clinical and radiological outcomes of lower limb fractures following surgical treatment in patients with chronic spinal cord injury (SCI).

methodsBetween January 2003 and December 2015, 102 chronic SCI patients with a lower limb fracture were surgically treated at our hospital. A total of 58 patients met the inclusion criteria and were recruited for final analysis. Patients with 2-stage procedure or incomplete clinical records with lost-to-follow-up were excluded from the study. Patients were divided into 2 groups (group 1= internal fixation; group 2 = external fixation). Primary outcome measures were to identify the number of nonunions via Kaplan-Meier analysis and the time to bone consolidation. The diagnosis of a pseudarthrosis was made after more than 180 days of consolidation time. Considering the Kaplan-Meier analysis, pseudarthrosis was interpreted as treatment failure. Secondary outcome measure was to evaluate the complication rate with special focus on heterotopic ossification.

resultsA total of 58 chronic SCI patients with closed bone fractures were included in this study. Fifty-two fractures (88%) were simple and 7 (12%) were complex (type C) fractures according to AO classification. The majority of patients (34 cases, 59%) developed femur fractures followed by 24 tibial fractures (41%). Seventeen patients received an external (29%) and 41 an internal fixation (71%). Bone consolidation was reported in 31 patients (53%) with a mean time interval of bone consolidation after 97 days (range from 45 to 160 days; SD = 30). The reported nonunion (pseudarthrosis) rate was 47%. Comparing the internal group (n = 15 patients) versus the external group (n = 14), we could not find any significant difference (

conclusionsOur results show that surgical treatment of lower limb fractures in chronic SCI patients is a challenging treatment with a high pseudarthrosis rate in both groups. The complication rate seems to be lower in the patients treated with external fixation. As a clinical recommendation, longer implants should be used for a stable osteosynthesis since SCI patients seem to have a higher load on the osteosynthesis material due to missing sensomotoric feedback.

Indexed as

femur fractureheterotopic ossificationinternal external fixationopen reduction and internal fixation (ORIF)spinal cord injurytibia fracture

Identifiers

PMID32707017
PMCPMC7383793
OpenAlexW2969279160

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.