Evidence map›Paper›PMID 33743770›Full record

ArticleJournal of orthopaedic surgery and research2021

C-Nail versus plate osteosynthesis in displaced intra-articular calcaneal fractures-a comparative retrospective study.

Eva Steinhausen, Wolfgang Martin, Rolf Lefering, Sven Lundin, Martin Glombitza, Bastian Mester, Nikolaus Brinkmann, Marcel Dudda

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

Article in Journal of orthopaedic surgery and research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 16% 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

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. [A prospective study on treatment of Sanders typeZhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2024
    Trial
  3. Article
  4. Article
  5. Article
  6. Article
  7. [Minimally Invasive Osteosynthesis with Intramedullary Nail: Evaluation of Outcomes].Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca · 2026
    Article
  8. Article
  9. Functional outcomes after intramedullary nailing (C-Nail®) of severe calcaneal fractures with mean follow-up of 36 months.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024
    Article
  10. Article
  11. Article
  12. 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 3 institutions in 1 country.

Eva Steinhausen *Department of Orthopedic and Trauma Surgery, BG Klinikum Duisburg, University of Duisburg-Essen, Großenbaumer Allee 250, 47249, Duisburg, Germany. Eva.Steinhausen@uni-due.de.
Wolfgang Martin *Department of Orthopedic and Trauma Surgery, BG Klinikum Duisburg, University of Duisburg-Essen, Großenbaumer Allee 250, 47249, Duisburg, Germany.
Rolf LeferingInstitute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Cologne, Germany.
Sven LundinDepartment of Orthopedic and Trauma Surgery, BG Klinikum Duisburg, University of Duisburg-Essen, Großenbaumer Allee 250, 47249, Duisburg, Germany.
Martin GlombitzaDepartment of Orthopedic and Trauma Surgery, BG Klinikum Duisburg, University of Duisburg-Essen, Großenbaumer Allee 250, 47249, Duisburg, Germany.
Bastian MesterDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Nikolaus BrinkmannDepartment of Orthopedic and Trauma Surgery, BG Klinikum Duisburg, University of Duisburg-Essen, Großenbaumer Allee 250, 47249, Duisburg, Germany.
Marcel DuddaDepartment of Orthopedic and Trauma Surgery, BG Klinikum Duisburg, University of Duisburg-Essen, Großenbaumer Allee 250, 47249, Duisburg, Germany.
University of Duisburg-Essen · DEBG Klinikum Duisburg · DEWitten/Herdecke University · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLocking plate osteosynthesis via an L-shaped lateral approach is the gold standard in treating displaced intra-articular calcaneal fractures. High complication rates are known for this approach. The most frequent complications are wound edge necrosis and superficial wound infections. To reduce complication rates, a locking intramedullary nail (C-Nail) was developed that can be implanted minimally invasively via a sinus tarsi approach. We compared the postoperative complication rate and the outcome of plate osteosynthesis versus C-Nail in displaced intra-articular calcaneal fractures.

methodsAll patients with calcaneal fractures who received osteosynthesis with either plate or C-Nail between January 2016 and October 2019 in our institution were retrospectively analyzed. A subgroup analysis was performed with matched pairs (matching Sanders type, age, Böhler's angle postoperative in normal range, 33 pairs). Endpoints were postoperative complication rate, bone healing, full weight-bearing and functional outcome. Treatment groups were compared using Fisher's exact test for binary data, and Mann-Whitney U-test for continuous data. A p-value < 0.05 was considered statistically significant.

resultsOne hundred and one calcaneal fractures were included (C-Nail n = 52, plate n = 49). Patients with C-Nail developed significantly less postoperative complications (p = 0.008), especially wound edge necrosis (p < 0.001). Screw malposition was found more often in the C-Nail group. The rates of achieving full weight-bearing as well as bone healing were comparable in both groups, but in each case significant faster in the C-nail subgroup. The results of the matched-pairs analysis were comparable.

conclusionsThe postoperative complication rate was significantly lower in the C-Nail group. The C-Nail appears to be a successful alternative in the treatment of calcaneal fractures, even in Sanders IV fractures because of the minimal-invasive implantation as well as the high primary stability. Long-term analysis of this new implant including elaboration on functional outcome is planned.

trial registrationDeutsches Register Klinischer Studien (DRKS) DRKS00020395 . Date of registration 3 January 2020.

Indexed as

Bone NailsBone PlatesAdultCalcaneusFemaleFracture Fixation, InternalHumansIntra-Articular FracturesMaleMiddle AgedOsteonecrosisPostoperative ComplicationsRetrospective StudiesSurgical Wound InfectionTreatment OutcomeWeight-BearingCalcaneal fractureCalcaneal nailExtensile lateral approachSinus tarsi approach

Identifiers

PMID33743770
PMCPMC7980618
OpenAlexW3137980565

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.