Evidence map›Paper›PMID 38372763›Full record

ArticleArchives of orthopaedic and trauma surgery2024

Comparing outcomes of plate augmentation, nail exchange, and nail exchange with plate augmentation in the treatment of atrophic femoral shaft nonunion after intramedullary nailing: a multicenter retrospective study.

Incheol Kook, Chang-Wug Oh, Oog-Jin Shon, Joon-Woo Kim, Ji-Wan Kim, Kyu Tae Hwang, Ki-Chul Park

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.9field-weighted citation impact, top 15% 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

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. 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

7 authors at 5 institutions in 1 country.

Incheol KookDepartment of Orthopaedic Surgery, Hanyang University Hospital, Seoul, South Korea.
Chang-Wug OhDepartment of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, South Korea.
Oog-Jin ShonDepartment of Orthopaedic Surgery, Yeungnam University Medical Center, Daegu, South Korea.
Joon-Woo KimDepartment of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, South Korea.
Ji-Wan KimDepartment of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Kyu Tae HwangDepartment of Orthopaedic Surgery, Hanyang University Hospital, Seoul, South Korea.
Ki-Chul ParkDepartment of Orthopaedic Surgery, Hanyang University Guri Hospital, 153, Gyeongchun-ro, Guri, Gyeonggi-do, 11923, South Korea. kcpark@hanyang.ac.kr.ORCID http://orcid.org/0000-0003-0938-8040
Hanyang University Seoul Hospital · KRUlsan College · KRHanyang University Guri Hospital · KRKyungpook National University Hospital · KRYeungnam University Medical Center · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIntramedullary (IM) nailing is the treatment of choice for femoral shaft fractures, but nonunion rates have been reported to be as high as 12%. Surgical interventions for nonunion involve exchange nailing or plate augmentation. Recently, a combined treatment of exchange nailing and plate augmentation has demonstrated good results, but its comparative effectiveness remains unclear. This study aimed to compare the clinical and radiographic outcomes of three different surgical interventions for atrophic femoral shaft nonunion, and investigate the factors that affect bone healing after reoperation. MATERIALS AND

methodsA retrospective study was conducted at five university hospitals involving 149 patients with aseptic atrophic nonunion after IM nailing. These patients underwent reoperation with plate augmentation, exchange nailing, or combined treatment. Clinical and radiographic outcomes were assessed and compared according to reoperation procedure. Logistic regression analysis was performed to identify factors affecting persistent nonunion after reoperation.

resultsOf the cohort, 57 patients underwent plate augmentation, 64 underwent exchange nailing, and 28 received combined treatment. There were no significant differences in patient demographics among the groups. Exchange nailing produced a significantly lower union rate than did the combined treatment (82.8% vs. 100%, p = 0.016), whereas no significant difference was observed in the union rate and time to the union between plate augmentation and the combined treatment. Combined treatment showed the longest operative time and the greatest transfusion requirements. The risk factors for persistent nonunion included age, absence of autogenous bone grafts, and use of an exchange nailing technique.

conclusionsExchange nailing as a treatment for atrophic femoral shaft nonunion after IM nailing resulted in a lower union rate. The efficacy of the combined treatment requires further study, and persistent nonunion may be influenced by age, bone grafting, and surgical techniques. A comprehensive approach targeting both biological environment and mechanical stability is crucial in the treatment of atrophic femoral shaft nonunion.

Indexed as

Femoral FracturesFracture Fixation, IntramedullaryFractures, UnunitedBone NailsFracture HealingHumansRetrospective StudiesTreatment OutcomeAtrophic nonunionExchange nailingFemoral shaft fractureIntramedullary nailingPersistent nonunionPlate augmentationRisk factor

Identifiers

PMID38372763
OpenAlexW4391943281

What OpenQuestion holds

Textmetadata
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.