Evidence map›Paper›PMID 37794410›Full record

Trial reportBMC musculoskeletal disorders2023

Treating peri-trochanteric hip fractures with intramedullary nail, when a second anti-rotational screw is necessary?

Panagiotis Tilaveridis, Efthymios Iliopoulos, Paraskevas Georgoulas, Georgios Drosos, Athanasios Ververidis, Konstantinos Tilkeridis

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report 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, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 19% 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, 2 syntheses or guidelines pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. 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

6 authors at 3 institutions in 1 country.

Panagiotis TilaveridisTrauma & Orthopaedics Department, General Hospital of Dramas, Drama, Greece.
Efthymios IliopoulosTrauma & Orthopaedics Department, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
Paraskevas GeorgoulasTrauma & Orthopaedics Department, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
Georgios DrososTrauma & Orthopaedics Department, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
Athanasios VerveridisTrauma & Orthopaedics Department, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
Konstantinos TilkeridisTrauma & Orthopaedics Department, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece. tilkerorth@icloud.com.
Democritus University of Thrace · GRUniversity Hospital of Alexandroupolis · GRGeneral Hospital of Drama · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFragility fractures around the proximal end of the femur have increased in recent years due to an aging population, adding to the pressure on national health care systems and to hospital expenses. Peri-trochanteric fractures have historically been treated successfully with anatomic intramedullary nails, giving stable fixation in order to allow early for mobilisation of these frail patients. Some of these nails allow a second (anti-rotational) screw through the nail into the femoral head. We assessed the use of this additional screw in terms of quality of reduction, post-operative mobilization and complications. MATERIALS &

methodsAll patients who were treated in the same hospital for peri-trochanteric fracture between January 2017 and December 2019 were included in the study. The patients were randomly assigned into group A, where the treatment included intramedullary nailing using one femoral hip screw, and group B, where the treatment additionally included a second anti-rotational screw. The patients were followed up clinically and radiologically, for at least 3 months post-operatively. Demographic and operative data were collected alongside radiographic and clinical data.

resultsA total of 118 patients with an average age of 82.7 years were included in the study after exclusion criteria was applied. There were no statistically significant differences between the two groups regarding the ASA grade, Nottingham Hip fracture score, Koval score, Mental score, operation time, transfusion requirements, and operative radiation dose and time (p > 0.05). In group A, more complications were observed (p < 0.05). The radiographic measurements were statistically significantly different. CART analysis revealed that the use of a single screw in the femoral head for the subgroup of the unstable peri-trochanteric fractures (Jensen Type 4-5 - AO31A2.2 and above), has a tendency toward developing more post-operative complications, though this was not statistically significant.

conclusionThe use of an additional anti-rotational screw for unstable peri-trochanteric fractures (Jensen Type 4-5 and AO 31A2.2 and above) could prevent complications such as varus collapse and cut-out.

Indexed as

Fracture Fixation, IntramedullaryHip FracturesAgedAged, 80 and overBone NailsBone ScrewsFracture Fixation, InternalHumansTreatment OutcomeAntirotation hip screwFracture complicationsFragility fracturesHip fracturesUnstable intertrochanteric fractures

Identifiers

PMID37794410
PMCPMC10548656
OpenAlexW4387339368

What OpenQuestion holds

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LicenceCC BY
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.