Evidence map›Paper›PMID 34398247›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022

Short-term outcome of isolated lateral malleolar fracture treatment is independent of hospital trauma volume or teaching status: a nationwide retrospective cohort study.

Malte Vehling, Claudio Canal, Franziska Ziegenhain, Hans-Christoph Pape, Valentin Neuhaus

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Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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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

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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

1 citing paper in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

5 authors.

Malte VehlingDivision of Trauma Surgery, Department of Traumatology, University Hospital Zurich, University of Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland.
Claudio CanalDivision of Trauma Surgery, Department of Traumatology, University Hospital Zurich, University of Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland.
Franziska ZiegenhainDivision of Trauma Surgery, Department of Traumatology, University Hospital Zurich, University of Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland.
Hans-Christoph PapeDivision of Trauma Surgery, Department of Traumatology, University Hospital Zurich, University of Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland.
Valentin NeuhausDivision of Trauma Surgery, Department of Traumatology, University Hospital Zurich, University of Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland. Valentin.neuhaus@gmx.ch.ORCID http://orcid.org/0000-0003-4012-5628

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIn light of current discussions about centralisation and teaching in medicine, we wanted to investigate the differences in in-hospital outcomes after surgical treatment of isolated ankle fractures, taking into account high-volume centres (HVCs) and low-volume centres (LVCs) and teaching procedures.

methodsA retrospective analysis of malleolar fractures recorded in a National Quality Assurance Database (AQC) from the period 01-01-1998 to 31-12-2018 was carried out. Inclusion criteria were isolated, and operatively treated lateral malleolar fractures (ICD-10 Code S82.6 and corresponding procedure codes). Variables were sought in bivariate and multivariate analyses. A total of 6760 cases were included. By dividing the total cases arbitrarily in half, 12 HVCs (n = 3327, 49%) and 56 LVCs (n = 3433, 51%) were identified.

resultsPatients in HVCs were younger (48 vs. 50 years old), had more comorbidities (26% vs. 19%) and had more open fractures (0.48% vs. 0.15%). Open reduction and internal fixation was the most common operative treatment at HVCs and LVCs (95% vs. 98%). A more frequent use of external fixation (2.5% vs. 0.55%) was reported at HVCs. There was no difference in mortality between treatment at HVCs and LVCs. A longer hospitalisation of 7.2 ± 5 days at HVCs vs. 6.3 ± 4.8 days at LVCs was observed. In addition, a higher rate of complications of 3.2% was found at HVCs compared to 1.9% at LVCs. The frequency of teaching operations was significantly higher at HVCs (30% vs. 26%). Teaching status had no influence on mortality or complications but was associated with a prolonged length of stay and operating time.

conclusionWe found significant differences between HVCs and LVCs in terms of in-hospital outcomes for ankle fractures. These differences could be explained due to a more severely ill patient population and more complex (also open) fracture patterns with resulting use of external fixation and longer duration of surgery. However, structural and organisational differences, such as an extended preoperative stays at HVCs and a higher teaching rate, were also apparent. No difference in mortality could be detected.

Indexed as

Ankle FracturesHospitals, Low-VolumeFracture Fixation, InternalHospitalizationHospitals, High-VolumeHumansMiddle AgedRetrospective StudiesTreatment OutcomeHigh-volumeLow-volumeMalleolar fractureOrthopaedic traumaOutcome

Identifiers

PMID34398247
PMCPMC9192439

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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.