Evidence map›Paper›PMID 37923919›Full record

ArticleJournal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology2023

Complication rates after proximal femoral nailing: does level of training matter?

D J Haslhofer, J M Stiftinger, N Kraml, F Dannbauer, C Schmolmüller, T Gotterbarm, O Kwasny, A Klasan

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Article in Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.3field-weighted citation impact, top 36% 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

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

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 1 institution in 1 country.

D J HaslhoferDepartment for Trauma Surgery and Sport Traumatology, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4020, Linz, Austria. david.haslhofer@gmx.at.ORCID http://orcid.org/0000-0002-8207-9757
J M StiftingerDepartment for Trauma Surgery and Sport Traumatology, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4020, Linz, Austria.
N KramlFaculty of Medicine, Johannes Kepler University Linz, Altenbergerstrasse 69, 4040, Linz, Austria.
F DannbauerDepartment for Trauma Surgery and Sport Traumatology, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4020, Linz, Austria.
C SchmolmüllerDepartment for Trauma Surgery and Sport Traumatology, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4020, Linz, Austria.
T GotterbarmDepartment for Orthopaedics and Traumatology, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4020, Linz, Austria.
O KwasnyDepartment for Trauma Surgery and Sport Traumatology, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4020, Linz, Austria.
A KlasanFaculty of Medicine, Johannes Kepler University Linz, Altenbergerstrasse 69, 4040, Linz, Austria.
Johannes Kepler University of Linz · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSurgical treatment of pertrochanteric fractures is one of the most performed surgeries in orthogeriatrics. Proximal femoral nailing, the most performed procedure, is often used as a training surgery for young residents. The objective of this study was to evaluate the relevance of the resident's training level to complication rates. MATERIAL AND

methodsThis study was a retrospective cohort study. Surgeons were divided into four groups according to their training level. Complications included infection, cut-out, and revision surgery. The study was performed at a level 1 trauma center. All patients who were treated with proximal femoral nailing surgery with a radiological follow-up of at least 3 months were included.

resultsOf the 955 patients extracted, a total of 564 patients met the inclusion criteria. Second-year residents had significantly higher cut-out rates (p = 0.012). Further analysis indicated a correlation between level of training and surgery duration (p < 0.001) as well as a correlation between surgery duration and infection rate (p < 0.001). The overall complication rate was 11.2%. Analyzing overall complications, no significant difference was found when comparing surgeon groups (p = 0.3). No statistically significant difference was found concerning infection (p = 0.6), cut-out (p = 0.7), and revision surgery (p = 0.3) either.

conclusionComplication rates after proximal femoral nailing are not higher in patients who are treated by residents. Therefore, proximal femoral nailing is an excellent procedure for general orthopedic training. However, we must keep in mind that accurate positioning of the femoral neck screw is essential to keep cut-out rates as low as possible. LEVEL OF EVIDENCE III:

Indexed as

Femoral FracturesFracture Fixation, IntramedullaryHip FracturesBone NailsBone ScrewsHumansRetrospective StudiesTreatment OutcomeComplication rateOrthogeriatricsPertrochanteric fractureProximal femoral nailingResident trainingRevision surgery

Identifiers

PMID37923919
PMCPMC10624794
OpenAlexW4388283045

What OpenQuestion holds

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LicenceCC BY
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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.