Evidence map›Paper›PMID 33635402›Full record

SynthesisArchives of orthopaedic and trauma surgery2022

Outcomes and complications following flexible intramedullary nailing for the treatment of tibial fractures in children: a meta-analysis.

Daniele Fanelli, Gerardo Perrotta, Fabio Stocco, Joshua Agilinko, Davide Castioni, Michele Mercurio, Giorgio Gasparini, Simon Barker

Abstract readMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Archives of orthopaedic and trauma surgery, 2022. 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
0.6field-weighted citation impact, top 33% 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, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Comparison of Three Surgical Options for Treatment of Diaphyseal Tibia Fractures in Pediatric Patients.Journal of the Pediatric Orthopaedic Society of North America · 2025
    Article
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 6 institutions in 2 countries.

Daniele Fanelli *Department of Trauma and Orthopaedic Surgery, Forth Valley Royal Hospital, Larbert, UK.
Gerardo Perrotta *GI Surgery Department, University College London Hospitals NHS Foundation Trust, London, UK.
Fabio Stocco *Division of Surgery and Anaesthetics, Huddersfield Royal Infirmary, Huddersfield, UK.
Joshua AgilinkoDepartment of General Surgery, North Middlesex University Hospital, London, UK.
Davide CastioniDepartment of Orthopaedic and Trauma Surgery, Magna Græcia" University, Mater Domini" University Hospital, V.Le Europa, (Loc. Germaneto), 88100, Catanzaro, Italy. davide.n.castioni@gmail.com.ORCID http://orcid.org/0000-0003-3207-6651
Michele MercurioDepartment of Orthopaedic and Trauma Surgery, Magna Græcia" University, Mater Domini" University Hospital, V.Le Europa, (Loc. Germaneto), 88100, Catanzaro, Italy.
Giorgio GaspariniDepartment of Orthopaedic and Trauma Surgery, Magna Græcia" University, Mater Domini" University Hospital, V.Le Europa, (Loc. Germaneto), 88100, Catanzaro, Italy.
Simon BarkerRoyal Aberdeen Children's Hospital, Aberdeen, UK.
Magna Graecia University · ITForth Valley Royal Hospital · GBHuddersfield Royal Infirmary · GBNorth Middlesex Hospital · GBRoyal Aberdeen Children's Hospital · GBUniversity College London Hospitals NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTibial shaft fractures are common occurrence in children and surgical treatment is sometimes required, particularly in unstable or open fractures, and in polytrauma. The aim of this study was to investigate the available evidence on the efficacy and safety of flexible intramedullary nailing (FIN) for both open and closed tibia fractures in children, exploring the main surgical outcomes and rate of complications. MATERIALS AND

methodsPubmed/Medline, Scopus and Cochrane Central databases were searched following the PRISMA guideline. Studies reporting on the outcomes of FIN for paediatric tibia shaft fractures were included. Weighted means were evaluated for surgical outcomes. Meta-analysis of proportion and odd ratios were used to analyse total complication rates and differences between open and closed fractures.

resultsTwenty-eight studies (835 patients) were included; the mean age was 11.0 ± 3.0 years. The mean follow-up was 22.5 ± 13.5 months; the mean time to full weight-bearing was 7.5 ± 3.7 weeks. The total complication rate was 28.1% (minor = 20.7%, major = 6.3%); this was greater in open fractures (13.6% vs 5.1%, p = 0.007). The rate of union was 97.5%, with a mean time to union of 11.9 ± 7.2 weeks. Malunion was found in 8.5% cases, delayed union in 3.8%, non-union in 1.4%, symptomatic hardware in 5.1%, leg-length discrepancy in 5.0%, superficial infections in 2.3%, deep infections in 1.0%, compartment syndromes in 1.4%, and refracture in 0.2%. Almost all patients returned to unrestricted physical activity.

conclusionsFIN offers excellent outcomes for the treatment of paediatric tibia shaft fractures. Patients presenting with an open fracture have a higher but acceptable complication rate. Comparative studies are needed to clarify if other treatments have superior outcomes.

Indexed as

Fracture Fixation, IntramedullaryFractures, OpenTibial FracturesAdolescentBone NailsChildFracture HealingHumansRetrospective StudiesTreatment OutcomeChildrenFixationIntramedullary nailingMalunionTibia fractureTrauma

Identifiers

PMID33635402
OpenAlexW3130751522

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.