Evidence map›Paper›PMID 36201033›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2023

Early peri-implant fractures after distal femur fracture locked plating?

Anna P Meyer, Thomas M Large

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 25% 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.

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

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5 · Who and what money

Authors and funding

2 authors at 2 institutions in 1 country.

Anna P MeyerEmory University Department of Orthopedic Surgery, Grady Memorial Hospital, Atlanta, GA, 30301, USA.
Thomas M LargeEmory University Department of Orthopedic Surgery, Grady Memorial Hospital, Atlanta, GA, 30301, USA. tmlarge@emory.edu.ORCID http://orcid.org/0000-0002-7087-0031
Grady Memorial Hospital · USMission Health · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo report the peri-implant fracture rates after locked plating of distal femur fractures and examine risk factors.

methodsOver a 7 year period, 89 AO/OTA 33A/C distal femur fractures were identified and reviewed. After excluding treatment with intramedullary nails, age under 50, those with the proximal femur protected, or those without 6 months of follow-up, 42 distal femur fractures in 41 patients, mean age 72.3 were studied. All were treated with lateral locked plating of distal femur fractures. The details of the constructs were recorded. Mean follow-up was 562 days (18.7 months).

results3/42 were open injuries, 9/42 were type C, 16/42 were type A, and 17 were periprosthetic above a knee arthroplasty. Two patients were treated with a dynamic plating construct using all far-cortical locking (FCL) screws in the diaphysis. 40 patients were treated with a variety of non-dynamic diaphyseal constructs including locking, non-locking, and four with 1-2 FCL screws distally. There was one asymptomatic nonunion. 2/2 patients in the dynamically plated group experienced a peri-implant fracture versus 1/40 in the non-dynamically plated group (p = 0.001). 3/9 with an all-locked construct versus 0/25 patients with a most proximal non-locking screw experienced a fracture.

conclusionsThe overall peri-implant fracture risk was 7.1% (3/42), 3/17 patients with a locking screw most proximal experienced a peri-implant fracture, 3/9 with an all-locking construct, and 2/2 patients with a dynamic construct experienced a fracture. These findings merit additional clinical and biomechanical study.

Indexed as

Femoral FracturesFemoral Fractures, DistalPeriprosthetic FracturesAgedBone PlatesChild, PreschoolFemurFracture Fixation, InternalHumansDistal femur fractureFractureLocked plateOsteosynthesisPeri-implant fracturePeriprosthetic fracturePlating

Identifiers

PMID36201033
OpenAlexW4302303849

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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.