Evidence map›Paper›PMID 38404536›Full record

ArticleOrthopedic research and reviews2024

External Fixation as a Primary and Definitive Treatment for Complex Tibial Diaphyseal Fractures: An Underutilized and Efficacious Approach.

Ahmed Albushtra, Abdulsalam Hadi Mohsen, Khaled Ali Alnozaili, Faisal Ahmed, Younes Mohsen Ali Abdu Aljobahi, Fawaz Mohammed, Mohamed Badheeb

Open access · goldAbstract read
In one paragraph

Article in Orthopedic research and reviews, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.8field-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

7 citing papers in PubMed, 2 citations in OpenAlex.

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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 4 institutions in 2 countries.

Ahmed AlbushtraDepartment of Orthopedic, School of Medicine, Ibb University, Ibb, Yemen.ORCID 0009-0002-1729-0545
Abdulsalam Hadi MohsenDepartment of Orthopedic, School of Medicine, Aden University, Aden, Yemen.
Khaled Ali AlnozailiDepartment of Orthopedic, School of Medicine, 21 September University, Sana'a, Yemen.
Faisal AhmedDepartment of Urology, School of Medicine, Ibb University, Ibb, Yemen.ORCID 0000-0001-7188-2715
Younes Mohsen Ali Abdu AljobahiDepartment of Orthopedic, School of Medicine, Ibb University, Ibb, Yemen.ORCID 0009-0009-0129-8850
Fawaz MohammedDepartment of Orthopedic, School of Medicine, Ibb University, Ibb, Yemen.ORCID 0000-0001-9256-3641
Mohamed BadheebDepartment of Internal Medicine, Yale New Haven Health, Bridgeport Hospital, Bridgeport, CT, USA.ORCID 0000-0001-8797-6329
Ibb University · YEBridgeport Hospital · USSana'a University · YEUniversity of Aden · YE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: External fixation is one of the most often utilized treatment options for complicated tibial diaphyseal fractures (TDF). The purpose of this study was to assess the efficacy of unilateral external fixators as primary and definitive therapy for complex TDF in a resource-limited setting. Materials and Methods: A retrospective study between June 2016 and March 2021 included 110 subjects with TDF who were treated with an external fixator as definitive fixation in hospitals affiliated with Ibb University. The patient's demographic characteristics, complications, and outcomes were gathered and analyzed. Factors associated with pin site infection were also investigated. Results: The mean age was 42.1 ± 10.1 years, with 92.7% being male. Rural residents accounted for 22.7%. Smoking and diabetes mellitus were present in 27.3% and 30.0%, respectively. General complications occurred in 12.0%, with pulmonary embolism being the most common at 4.5%. Orthopedic complications included pin-track infections in 27.3% (30) and osteomyelitis in 1.8% (2). Pin site infections required medical treatment in 21 cases and external fixator changes in five. Two cases each needed several debridements for osteomyelitis and soft tissue. Full union occurred in 79.1% (87) over 23.1 ± 3.2 weeks and final alignment in 97.3% (107) over 34.8 ± 4.8 weeks. Malunions occurred in 1.8% (2), and one case had hypertrophic nonunion. Factors like rural residency, smoking, diabetes, open fractures, worst fracture grade (Gustilo and Anderson type C), and general complications occurrence significantly correlated with pin site infection (all p-values < 0.05). Conclusion: A unilateral external fixator as a primary and definitive treatment is a viable, simple, and effective option for TDF with a high success rate even in a resource-limited setting. In this study, residents in rural areas, smoking, diabetes, open fracture, worst fracture grade, and general complication occurrence were associated with pin site infection occurrence.

Indexed as

definitive treatmentexternal fixationpin tract infectiontibial fractures

Identifiers

PMID38404536
PMCPMC10894515
OpenAlexW4392013387

What OpenQuestion holds

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LicenceCC BY-NC
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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.