Evidence map›Paper›PMID 34789313›Full record

ArticleJournal of orthopaedic surgery and research2021

Characteristics of intramedullary nail breakage in pertrochanteric femur fractures: a summary of 70 cases.

Pengfei Li, Zhishan Zhang, Fang Zhou, Yang Lv, Yan Guo, Yun Tian

Open access · goldAbstract readCase Reports
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 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.9field-weighted citation impact, top 8% 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

9 citing papers in PubMed, 21 citations in OpenAlex.

  1. Article
  2. Article
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  4. Impact of lateral cortical notching on biomechanical performance in cephalomedullary nailing for unstable pertrochanteric fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024
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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Pengfei LiDepartment of Orthopaedics, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing, 100191, People's Republic of China.
Zhishan ZhangDepartment of Orthopaedics, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing, 100191, People's Republic of China. ltlxl@sina.com.
Fang ZhouDepartment of Orthopaedics, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing, 100191, People's Republic of China. zhouf@bjmu.edu.cn.
Yang LvDepartment of Orthopaedics, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing, 100191, People's Republic of China.
Yan GuoDepartment of Orthopaedics, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing, 100191, People's Republic of China.
Yun TianDepartment of Orthopaedics, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing, 100191, People's Republic of China.
Peking University Third Hospital · CNPeking University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo reveal noteworthy characteristics of intramedullary (IM) nail breakage in pertrochanteric femur fractures. MATERIALS AND

methodsThe data from 6 patients with IM nail breakage in our hospital between August 2008 and May 2018 were reviewed retrospectively. With an additional 64 cases reported in articles in the PubMed database prior to October 2019, a total of 70 cases were reviewed and analysed; epidemiological patient data and data on the initial trauma, fracture type, nail selected for the original surgery, time from surgery to breakage, mechanism and location of breakage, status of fracture healing, salvage treatment and prognosis were assessed.

resultsSeventy patients with pertrochanteric fractures, including 2 stable fractures and 68 unstable fractures, experienced IM nail breakage at a mean of 9.4 months after the initial surgery. Among them, 9 (12.9%) occurred within 3 months, 23 (32.9%) between 3 and 6 months and 38 (54.3%) after 6 months. The mean age was 72.3 years, and 16 (22.9%) patients were younger than 65 years old. When nail breakage occurred, 66 fractures (94.3%) exhibited delayed union/non-union. Self-dynamisation was found in 12 cases (17.1%). The salvage procedures included 4 partial/total implant removal procedures, 17 hemi/total hip arthroplasty procedures, 3 conservative treatment procedures, and 46 revised osteosyntheses, of which 7 cases (15.2%) sustained secondary implant failure. No significant differences were found between the failure rates of IM nails and extramedullary(EM) devices (odds ratio [OR], 3.429; 95% confidence interval [CI], 0.632-18.877; p = 0.330).

conclusionIM nail breakage is a rare complication lack of time regularity and mostly occurs in unstable pertrochanteric fractures in the presence of delayed union/non-union. Osteosynthesis revision can be conduct by a new IM nail or EM device but considerable secondary failure rate is noteworthy. Self-dynamisation may be a warning sign of nail breakage.

Indexed as

Femoral FracturesFracture Fixation, IntramedullaryHip FracturesAgedBone NailsFemurHumansRetrospective StudiesTreatment OutcomeIntramedullary nail breakagePertrochanteric fracturesRevision surgerySelf-dynamisationUnstable fractures

Identifiers

PMID34789313
PMCPMC8597261
OpenAlexW3213257726

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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.