Evidence map›Paper›PMID 37497387›Full record

ArticleOTA international : the open access journal of orthopaedic trauma2023

Predictors of nonunion for transverse femoral shaft fractures treated with intramedullary nailing: a SIGN database study.

Brett Jones, Blake Cohoe, Kelsey Brown, Michael Flores, Kevin Peurrung, Terry Smith, David Shearer, Lewis Zirkle

Open access · goldAbstract read
In one paragraph

Article in OTA international : the open access journal of orthopaedic trauma, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 29% 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

2 citing papers in PubMed, 3 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

8 authors at 2 institutions in 1 country.

Brett JonesElson S. Floyd College of Medicine, Spokane, WA.ORCID https://orcid.org/0000-0002-7293-6241
Blake CohoeElson S. Floyd College of Medicine, Spokane, WA.
Kelsey BrownInstitute for Global Orthopedics and Traumatology, Department of Orthopaedic Surgery, University of California, San Francisco, CA.
Michael FloresInstitute for Global Orthopedics and Traumatology, Department of Orthopaedic Surgery, University of California, San Francisco, CA.
Kevin PeurrungSIGN Fracture Care International, Richland, WA.
Terry SmithSIGN Fracture Care International, Richland, WA.
David ShearerInstitute for Global Orthopedics and Traumatology, Department of Orthopaedic Surgery, University of California, San Francisco, CA.
Lewis ZirkleSIGN Fracture Care International, Richland, WA.
University of California, San Francisco · USWashington State University Spokane · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Nonunion is a common postfracture complication resulting in decreased quality of life for patients in resource-limited settings. This study aims to determine how age, sex, injury mechanism, and surgical intervention affect the rate of nonunion in transverse femur fractures treated with a SIGN intramedullary nail (IMN). Methods: A retrospective study was conducted using the SIGN online surgical database. All patients older than 16 years with simple transverse (<30 degrees), open or closed, femur fractures treated using a SIGN IMN between 2007 and 2021 were included. Our primary outcome of nonunion was measured with the modified Radiographic Union Scale for Tibial fractures (mRUST); scores ≤9 of 16 defined nonunion. The secondary outcome was squat depth. Outcomes were evaluated at follow-up appointments between 240 and 365 days postoperatively. Univariate and multivariate analysis were used for statistical comparison. Results: Inclusion criteria were met for 182 patients. The overall radiographic union rate was 61.0%, and a high proportion (84.4%) of patients could squat with their hips at or below the level of their knees. Older age, retrograde approach, and fracture distraction were associated with nonunion, but sex, injury mechanism, and other surgical variables were not. Conclusion: Poor reduction with fracture distraction was associated with a higher rate of nonunion. Loss of follow-up may have contributed to our overall union rate; however, we observed high rates of functional healing using the SIGN IMN. Level of evidence: IV.

Indexed as

global healthnonuniontransverse femur fracturetrauma

Identifiers

PMID37497387
PMCPMC10368386
OpenAlexW4385239363

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.