Evidence map›Paper›PMID 37210475›Full record

ArticleBMC musculoskeletal disorders2023

Which non-infection related risk factors are associated with impaired proximal femur fracture healing in patients under the age of 70 years?

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

Open access · goldAbstract read
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In one paragraph

Article in BMC musculoskeletal disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
3.2field-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

5 citing papers in PubMed, 10 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

7 authors at 3 institutions in 2 countries.

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.
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.
Till BerkDepartment of Trauma, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. Till.Berk@usz.ch.ORCID http://orcid.org/0000-0001-9582-1810
University of Zurich · CHAO Foundation · CHUniversity of Wisconsin–Madison · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background/purposeImpaired healing is a feared complication with devastating outcomes for each patient. Most studies focus on geriatric fracture fixation and assess well known risk factors such as infections. However, risk factors, others than infections, and impaired healing of proximal femur fractures in non-geriatric adults are marginally assessed. Therefore, this study aimed to identify non-infection related risk factors for impaired fracture healing of proximal femur fractures in non-geriatric trauma patients.

methodsThis study included non-geriatric patients (aged 69 years and younger) who were treated between 2013 and 2020 at one academic Level 1 trauma center due to a proximal femur fracture (PFF). Patients were stratified according to AO/OTA classification. Delayed union was defined as failed callus formation on 3 out of 4 cortices after 3 to 6 months. Nonunion was defined as lack of callus-formation after 6 months, material breakage, or requirement of revision surgery. Patient follow up was 12 months.

resultsThis study included 150 patients. Delayed union was observed in 32 (21.3%) patients and nonunion with subsequent revision surgery occurred in 14 (9.3%). With an increasing fracture classification (31 A1 up to 31 A3 type fractures), there was a significantly higher rate of delayed union. Additionally, open reduction and internal fixation (ORIF) (OR 6.17, (95% CI 1.54 to 24.70, p ≤ 0.01)) and diabetes mellitus type II (DM) (OR 5.74, (95% CI 1.39 to 23.72, p = 0.016)), were independent risk factors for delayed union. The rate of nonunion was independent of fracture morphology, patient's characteristics or comorbidities.

conclusionIncreasing fracture complexity, ORIF and diabetes were found to be associated with delayed union of intertrochanteric femur fractures in non-geriatric patients. However, these factors were not associated with the development of nonunion.

Indexed as

Femoral FracturesProximal Femoral FracturesAdultFemurFracture Fixation, InternalFracture HealingHumansRetrospective StudiesRisk FactorsTreatment OutcomeDelayed unionNon-geriatricNonunionPolytraumaRisk factorsTraumatic proximal femur fractures

Identifiers

PMID37210475
PMCPMC10199638
OpenAlexW4377130564

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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.