Evidence map›Paper›PMID 36544094›Full record

ArticleBMC geriatrics2022

Trochanteric fracture pattern is associated with increased risk for nonunion independent of open or closed reduction technique.

Till Berk, Sascha Halvachizadeh, David Paul Martin, Christian Hierholzer, Dominik Müller, Roman Pfeifer, Gerrolt Nico Jukema, Boyko Gueorguiev, Hans-Christoph Pape

Open access · goldAbstract read
In one paragraph

Article in BMC geriatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.7field-weighted citation impact, top 15% 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

4 citing papers in PubMed, 8 citations in OpenAlex.

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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

9 authors at 4 institutions in 2 countries.

Till BerkDepartment of Trauma, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. Till.Berk@usz.ch.ORCID 0000-0001-9582-1810
Sascha HalvachizadehDepartment of Trauma, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
David Paul MartinDepartment of Orthopedics and Rehabilitation, University of Wisconsin, 1685 Highland Ave, Madison, WI, 53705, USA.
Christian HierholzerDepartment of Trauma, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Dominik MüllerCantonal Hospital Frauenfeld, Pfaffenholzstrasse 4, 8501, Frauenfeld, Switzerland.
Roman PfeiferDepartment of Trauma, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Gerrolt Nico JukemaDepartment of Trauma, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Boyko GueorguievAO Research Institute Davos, Clavadelerstrasse 8, 7270, Davos, Switzerland.
Hans-Christoph PapeDepartment of Trauma, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
University of Zurich · CHAO Foundation · CHKantonsspital Frauenfeld · CHUniversity of Wisconsin–Madison · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSoft tissue injury and soft tissue injury as risk factors for nonunion following trochanteric femur fractures (TFF) are marginally investigated. The aim of this study was to identify risk factors for impaired fracture healing in geriatric trauma patients with TFF following surgical treatment with a femoral nail.

methodsThis retrospective cohort study included geriatric trauma patients (aged > 70 years) with TFF who were treated with femoral nailing. Fractures were classified according to AO/OTA. Nonunion was defined as lack of callus-formation after 6 months, material breakage, and requirement of revision surgery. Risk factors for nonunion included variables of clinical interest (injury pattern, demographics, comorbidities), as well as type of approach (open versus closed) and were assessed with uni- and multivariate regression analyses.

resultsThis study included 225 geriatric trauma patients. Nonunion was significantly more frequently following AO/OTA 31A3 fractures (N = 10, 23.3%) compared with AO/OTA type 31A2 (N = 6, 6.9%) or AO/OTA 31A1 (N = 3, 3.2%, p < 0.001). Type 31A3 fractures had an increased risk for nonunion compared with type 31A1 (OR 10.3 95%CI 2.2 to 48.9, p = 0.003). Open reduction was not associated with increased risk for nonunion (OR 0.9, 95%CI 0.1 to 6.1. p = 0.942) as was not the use of cerclage (OR 1.0, 95%CI 0.2 to 6.5, p = 0.995). Factors such as osteoporosis, polytrauma or diabetes were not associated with delayed union or nonunion.

conclusionThe fracture morphology of TFF is an independent risk factor for nonunion in geriatric patients. The reduction technique is not associated with increased risk for nonunion, despite increased soft tissue damage following open reduction.

Indexed as

Femoral FracturesFracture Fixation, IntramedullaryHip FracturesSoft Tissue InjuriesAgedHumansRetrospective StudiesTreatment OutcomeDelayed unionGeriatric traumaNonunionPolytraumaRisk factorsTraumatic proximal femur fractures

Identifiers

PMID36544094
PMCPMC9773584
OpenAlexW4312190945

What OpenQuestion holds

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LicenceCC BY
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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.