Evidence map›Paper›PMID 37442585›Full record

Trial reportCanadian journal of surgery. Journal canadien de chirurgie

Reamed compared with unreamed nailing of tibial shaft fractures: Does the initial method of nail insertion influence outcome in patients requiring reoperations?

Emil H Schemitsch, Ashesh Kumar, Diane Heels-Ansdell, Sheila Sprague, Mohit Bhandari, Gordon Guyatt, David W Sanders, Marc Swiontkowski, Paul Tornetta, Stephen Walter and 1 more

Registry-linked trialOpen access · diamondAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Canadian journal of surgery. Journal canadien de chirurgie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00038129 (Study to Prospectively Evaluate Reamed Intramedullary Nails in Tibial Shaft Fractures), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 43% 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.

NCT00038129 nacompletednot on this map

Study to Prospectively Evaluate Reamed Intramedullary Nails in Tibial Shaft Fractures (SPRINT)

TypeinterventionalSponsorUniversity of MinnesotaRan2002 to 2006Enrolled1,200ConditionsTibial FractureArmsIntramedullary nail implant
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Article
  2. 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 at 6 institutions in 3 countries.

Emil H SchemitschDivision of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta) Emil.Schemitsch@lhsc.on.ca.
Ashesh KumarDivision of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta).
Diane Heels-AnsdellDivision of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta).
Sheila SpragueDivision of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta).
Mohit BhandariDivision of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta).
Gordon GuyattDivision of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta).
David W SandersDivision of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta).
Marc SwiontkowskiDivision of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta).
Paul TornettaDivision of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta).
Stephen WalterDivision of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta).
SPRINT Investigators
Western University · CASt. Michael's Hospital · CAWestern University of Health Sciences · USBoston Medical Center · USLondon Health Sciences Centre · CAUniversity of Minnesota · US

Funding

SPRINT- Randomized Trial of Tibial Fracture FixationR01AR048529 · NIAMS · UNIVERSITY OF MINNESOTA TWIN CITIES · PI SWIONTKOWSKI, MARC F · 2002 to 2006
$1.1M
NIAMS NIH HHS R01 AR048529
6 · The paper itself

Abstract

backgroundPatients with a tibial shaft fracture experiencing their first postoperative complication following treatment with intramedullary nails may be at greater risk of subsequent complications than the whole population. We aimed to determine whether the initial method of nail insertion influences outcome in patients with a tibial shaft fracture requiring multiple reoperations.

methodsUsing the Study to Prospectively Evaluate Reamed Intramedullary Nails in Tibial Shaft Fractures trial data, we categorized patients as those not requiring reoperation, those requiring a single reoperation and those requiring multiple reoperations, and we compared them by nail insertion technique (reamed v. unreamed) and fracture type (open v. closed). We then determined the number of patients whose first reoperation was in response to infection, and we compared other clinical outcomes between the reamed and unreamed groups.

resultsAmong 1226 patients included in this analysis, 175 (14.27%) experienced a single reoperation and 44 patients (3.59%) underwent multiple reoperations. Nail insertion techniques (reamed v. unreamed) did not play a role in the need to perform multiple reoperations. Seventy-five percent of patients requiring multiple reoperations had open tibial shaft fractures. An equal number of these were reamed and unreamed insertions. The majority of patients had their course complicated by infection and almost 50% of patients whose first reoperation was for infection required more than 2 reoperations for management. The rest required multiple procedures for nonunion or bone loss.

conclusionOur findings corroborate those of other studies, in which open fracture type rather than nail insertion technique was found to be the cause of morbidity following intramedullary nailing of tibial fractures. CLINICAL

trial registrationwww. CLINICALTRIALS: gov, no. NCT00038129.

Indexed as

Fracture Fixation, IntramedullaryTibial FracturesBone NailsFracture HealingHumansPostoperative ComplicationsReoperationTibia

Identifiers

PMID37442585
PMCPMC10355994
OpenAlexW4384199815

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

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.