Evidence map›Paper›PMID 34984496›Full record

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

MIPO vs. intra-medullary nailing for extra-articular distal tibia fractures and the efficacy of intra-operative alignment control: a retrospective cohort of 135 patients.

Nils Jan Bleeker, Nicole M van Veelen, Bryan J M van de Wall, Inger N Sierevelt, Björn-Christian Link, Reto Babst, Matthias Knobe, Frank J P Beeres

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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 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. The semi-extended infrapatellar intramedullary nailing of distal tibia fractures: a randomized clinical trial.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2022
    Trial
  3. Article
  4. Article
  5. [Comparison of effectiveness of tibial intramedullary nailing fixation via suprapatellar approach and medial parapatellar approach in treatment of multiple tibial fractures].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2024
    Article
  6. 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.

Nils Jan BleekerDepartment of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne (LUKS), Lucerne, Switzerland.ORCID http://orcid.org/0000-0002-1221-6058
Nicole M van VeelenDepartment of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne (LUKS), Lucerne, Switzerland.
Bryan J M van de WallDepartment of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne (LUKS), Lucerne, Switzerland.
Inger N SiereveltSpecialized Center of Orthopaedic Research and Education (SCORE), Orthopaedic Department, Xpert Clinics, Amsterdam, The Netherlands.
Björn-Christian LinkDepartment of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne (LUKS), Lucerne, Switzerland.
Reto BabstDepartment of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne (LUKS), Lucerne, Switzerland.
Matthias KnobeDepartment of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne (LUKS), Lucerne, Switzerland.
Frank J P BeeresDepartment of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne (LUKS), Lucerne, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDefinitive treatment of distal extra-articular fractures of the tibia is challenging and both minimal invasive plate osteosynthesis (MIPO) and intramedullary nailing (IMN) are considered to be feasible surgical modalities with their own implant-specific merits and demerits. This retrospective study was designed to compare MIPO versus IMN in terms of fracture healing, complications, functional and radiological outcomes and to assess the efficacy of intra-operative alignment control to reduce the rate of malalignment after definitive fixation of distal extra-articular fractures of the tibia. MATERIALS AND

methodsAll consecutive adult patients with extra-articular distal meta- or diaphyseal tibia fractures that were treated between January 2012 and September 2019 either with MIPO or IMN were included. Outcome measures included fracture healing, complications (infection, malalignment, subsequent surgeries), functional and radiological outcomes. Intra-operative alignment control encompassed bilateral draping of the lower extremities.

resultsA total of 135 patients were included out of which 72 patients (53%) were treated with MIPO and 63 patients (47%) underwent IMN. There was a significantly higher incidence of non-union for fractures treated with IMN (13 (22%) vs. 4 (6%), p = 0.04). There was no significant difference between both groups in terms of rotational malalignment (3% vs. 10%) and angular malalignment (4% vs. 5%). A significantly higher rate of infection was found after MIPO after correction of significant differences in baseline characteristics. No differences were found in subsequent surgeries or functional outcomes.

conclusionBoth MIPO and IMN are reliable surgical techniques. IMN is associated with higher rates of non-union, whereas MIPO results in a higher risk for infection. The incidence of malalignment was surprisingly low endorsing the utility of the intra-operative alignment control.

Indexed as

Ankle FracturesFracture Fixation, IntramedullaryTibial FracturesAdultBone PlatesFracture Fixation, InternalFracture HealingHumansMinimally Invasive Surgical ProceduresRetrospective StudiesTibiaTreatment OutcomeBilateral drapingDistal tibia fracturesIMNMalalignmentMIPOPostoperative outcomes

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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.