Evidence map›Paper›PMID 37052677›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2023

Comparison of post-op opioid use and pain between short and long cephalomedullary nails in elderly intertrochanteric fractures.

Richard W Pectol, Matthew W Kavolus, Axel Kiefer, Chandler R Sneed, Tanner Womble, Jeffrey A Foster, Daria L Kinchelow, Gregory S Hawk, Paul E Matuszewski, David C Landy and 1 more

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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 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

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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.

  1. 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

11 authors.

Richard W PectolDepartment of Orthopaedic Surgery & Sports Medicine, University of Kentucky, 780 Rose St., MN508, Lexington, KY, 40536, USA.ORCID http://orcid.org/0000-0002-6821-3382
Matthew W KavolusDepartment of Orthopaedic Surgery & Sports Medicine, University of Kentucky, 780 Rose St., MN508, Lexington, KY, 40536, USA.ORCID http://orcid.org/0000-0002-3712-1792
Axel KieferDepartment of Orthopaedic Surgery & Sports Medicine, University of Kentucky, 780 Rose St., MN508, Lexington, KY, 40536, USA.
Chandler R SneedDepartment of Orthopaedic Surgery & Sports Medicine, University of Kentucky, 780 Rose St., MN508, Lexington, KY, 40536, USA.ORCID http://orcid.org/0000-0001-8640-7124
Tanner WombleDepartment of Orthopaedic Surgery & Sports Medicine, University of Kentucky, 780 Rose St., MN508, Lexington, KY, 40536, USA.ORCID http://orcid.org/0000-0002-2916-213X
Jeffrey A FosterDepartment of Orthopaedic Surgery & Sports Medicine, University of Kentucky, 780 Rose St., MN508, Lexington, KY, 40536, USA. austin.foster@uky.edu.ORCID http://orcid.org/0000-0003-3875-5401
Daria L KinchelowDepartment of Orthopaedic Surgery & Sports Medicine, University of Kentucky, 780 Rose St., MN508, Lexington, KY, 40536, USA.ORCID http://orcid.org/0000-0002-0185-6068
Gregory S HawkDepartment of Statistics, University of Kentucky, Lexington, KY, USA.ORCID http://orcid.org/0000-0001-8935-9965
Paul E MatuszewskiDepartment of Orthopaedic Surgery & Sports Medicine, University of Kentucky, 780 Rose St., MN508, Lexington, KY, 40536, USA.ORCID http://orcid.org/0000-0002-1340-0412
David C LandyDepartment of Orthopaedic Surgery & Sports Medicine, University of Kentucky, 780 Rose St., MN508, Lexington, KY, 40536, USA.ORCID http://orcid.org/0000-0002-4024-7679
Arun AnejaDepartment of Orthopaedic Surgery & Sports Medicine, University of Kentucky, 780 Rose St., MN508, Lexington, KY, 40536, USA.ORCID http://orcid.org/0000-0002-1507-6863

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIt remains unknown if cephalomedullary nail (CMN) length has an impact on pain and opioid use following fixation. Given the lack of level I evidence favoring a specific CMN length to prevent adverse surgical outcomes, we investigated if CMN length impacts acute postoperative pain and opioid use. The authors hypothesize that the use of longer CMNs results in increased pain scores and morphine milligram equivalents (MME) intake during the 0-24 h (h) and 24-36 h postoperative period.

methodsA retrospective chart review was performed from 2010 to 2020 of patients ≥ 65 years-old who underwent CMN for IT fractures and fractures with subtrochanteric extension (STE). We compared patients who received short and long CMNs using numeric rating scale (NRS) pain scores and MME intake at 0-24 h and 24-36 h postoperatively.

results330 patients receiving short (n = 155) and long (n = 175) CMNs met criteria. CMN length was found to not be associated with higher pain scores in the early postoperative phase. However, patients with long CMNs received higher MME from 0-24 h (25.4% estimated mean increase, p value = 0.02) and 24-36 h (22.3% estimated mean increase, p value = 0.04) postoperatively, even after adjusting for covariates, gender, and age.

conclusionPatients with long CMNs received greater MME postoperatively. Additionally, differences in pain and MME were not significantly different between patients with and without STE, suggesting our findings were not influenced by this pattern. These results suggest longer CMNs are associated with higher acute postoperative opioid intake among patients with IT fractures. LEVEL OF EVIDENCE: Therapeutic level III.

Indexed as

Fracture Fixation, IntramedullaryHip FracturesAgedAnalgesics, OpioidBone NailsEndrinHumansNailsPostoperative PainRetrospective StudiesAnalgesics, OpioidEndrinMMECephalomeduallary NailElderlyHip FractureIntertrochanteric FractureOpioidsPain

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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.