Evidence map›Paper›PMID 38615140›Full record

SynthesisJournal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology2024

Interlocking intramedullary nail for forearm diaphyseal fractures in adults-A systematic review and meta-analysis of outcomes and complications.

Ali Lari, Yousef Hassan, Abdulwahab Altammar, Ali Esmaeil, Abdulaziz Altammar, Carlos Prada, Ali Jarragh

Open access · goldAbstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 12% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Higher nonunion rates with locking plates compared to dynamic compression plates in forearm diaphyseal fractures: a multicenter study.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2025
    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 3 institutions in 2 countries.

Ali LariDepartment of Orthopedic Surgery, AlRazi National Orthopedic Hospital, Kuwait City, Kuwait. Dr.alilari@gmail.com.ORCID http://orcid.org/0000-0002-2070-6727
Yousef HassanDepartment of Orthopedic Surgery, AlRazi National Orthopedic Hospital, Kuwait City, Kuwait.
Abdulwahab AltammarDepartment of Orthopedic Surgery, AlRazi National Orthopedic Hospital, Kuwait City, Kuwait.
Ali EsmaeilDepartment of Orthopedic Surgery, AlRazi National Orthopedic Hospital, Kuwait City, Kuwait.
Abdulaziz AltammarDepartment of Orthopedic Surgery, AlRazi National Orthopedic Hospital, Kuwait City, Kuwait.
Carlos PradaSt Joseph's Health Care, Hand and Upper Limb Centre, University of Western Ontario, London, ON, Canada.
Ali JarraghDepartment of Orthopedic Surgery, Kuwait University, Kuwait City, Kuwait.
Amiri Hospital · KWKuwait University · KWWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this systematic review is to examine the outcomes, complications, and potential advantages of using anatomical interlocking intramedullary nails (IMN) in the treatment of radius and ulnar shaft diaphyseal fractures in adults.

methodsMedline, Embase, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched between January 2000 and January 2023. Studies meeting criteria were observational or randomized controlled trials evaluating outcomes in IMN for adult diaphyseal forearm fractures. Standardized data extraction was performed and a quality assessment tool was used to evaluate individual study methodology. Descriptive statistics for interventions, functional outcomes, and complications were reported. Meta-analysis was performed for patient-reported outcome measures and operative time.

resultsA total of 29 studies involving 1268 patients were included with 764 (60%) undergoing IMN, 21% open reduction and internal fixation (ORIF), and 9% hybrid fixation. There was no significant difference between groups in DASH and Grace-Eversmann scores. Operative time was significantly shorter in IMN compared with ORIF. The DASH scores were: 13.1 ± 6.04 for IMN, 10.17 ± 3.98 for ORIF, and 15.5 ± 0.63 in hybrids. Mean operative time was 65.3 ± 28.7 in ORIF and 50.8 ± 17.7 in IMN. Complication rates were 16.7% in the IMN group, 14.9% in ORIF, and 6.3% in hybrid constructs. There were 11 cases of extensor pollicis rupture in the IMN group. Average IMN pronation and supination were 78.3° ± 7.9° and 73° ± 5.0°, respectively. Average ORIF pronation and supination was 82.15° ± 1.9° and 79.7° ± 4.5°, respectively.

conclusionsSimilar functional outcomes and complication rates along with shorter operative times can be achieved with IMN compared with ORIF. The use of IMN is promising, however, higher quality evidence is required to assess appropriate indications, subtle differences in range of motion, implant-related complications, and cost-effectiveness. Trail Registration PROSPERO (International Prospective Register of Systematic Reviews) (ID: CRD42022362353). LEVEL OF EVIDENCE III:

Indexed as

Bone NailsFracture Fixation, IntramedullaryRadius FracturesUlna FracturesAdultDiaphysesHumansOperative TimePostoperative ComplicationsTreatment OutcomeDiaphysisForearm fracturesInterlocking nailIntramedullary nailNlnaRadius

Identifiers

PMID38615140
PMCPMC11016039
OpenAlexW4394786572

What OpenQuestion holds

Textmetadata
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.