Evidence map›Paper›PMID 38919353›Full record

ArticleThe Iowa orthopaedic journal2024

Temporary Stabilization of Tibia Fractures: Does External Fixation or Temporary Plate Fixation Result in Better Outcomes?

Cody L Walters, Samuel K Simister, Shannon Tse, Aziz Saade, Mark F Megerian, Ellen P Fitzpatrick, Gillian L Soles, Mark A Lee, Augustine M Saiz, Sean T Campbell

Abstract readComparative Study
In one paragraph

Article in The Iowa orthopaedic journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

10 authors.

Cody L WaltersUC Davis School of Medicine, Sacramento, California, USA.
Samuel K SimisterDepartment of Orthopedic Surgery, UC Davis Medical Center, Sacramento, California, USA.
Shannon TseDepartment of Orthopedic Surgery, UC Davis Medical Center, Sacramento, California, USA.
Aziz SaadeDepartment of Orthopedic Surgery, UC Davis Medical Center, Sacramento, California, USA.
Mark F MegerianCase Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Ellen P FitzpatrickDepartment of Orthopedic Surgery, UC Davis Medical Center, Sacramento, California, USA.
Gillian L SolesDepartment of Orthopedic Surgery, UC Davis Medical Center, Sacramento, California, USA.
Mark A LeeDepartment of Orthopedic Surgery, UC Davis Medical Center, Sacramento, California, USA.
Augustine M SaizDepartment of Orthopedic Surgery, UC Davis Medical Center, Sacramento, California, USA.
Sean T CampbellDepartment of Orthopedic Surgery, UC Davis Medical Center, Sacramento, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Provisional stabilization of high-energy tibia fractures using temporary plate fixation (TPF) or external fixation (ex-fix) prior to definitive medullary nailing (MN) is a strategy common in damage control orthopaedics. There is a lack of comprehensive data evaluating outcomes between these methods. This study compares outcomes of patients stabilized with either TPF or ex-fix, and with early definitive MN only, assessing complications including nonunion and deep infection. Methods: A retrospective review was performed on adult patients with tibia fractures treated with MN followed until fracture union (≥3 months) at a single level-1 trauma center from 2014 to 2022. Medical records were evaluated for nonunion and deep infection. Demographics, injury characteristics, and fixation methods were recorded. Significance between patients who underwent TPF and ex-fix was compared with a matched cohort of early MN using Pearson's exact tests, independent t-tests, and one-way ANOVA, depending on the appropriate variable. Results: 81 patients were included; 27 were temporized with TPF (n = 12) or ex-fix (n = 15). 54 early MN cases defined the matched cohort. All groups had similar patient and fracture characteristics. The difference in rates of nonunion between groups was significant, with TPF, ex-fix, and early MN groups at 17, 40, and 11% respectively (p = 0.027). Early MN had lower rates of nonunion (11% vs. 40%, p = 0.017) and deep infection (13% vs. 40%, p = 0.028) compared to ex-fix. Conclusion: Temporary ex-fix followed by staged MN was associated with higher rates of nonunion and deep infection. There was no difference in complication rates between TPF and early definitive MN. These data suggest that ex-fix followed by MN of tibia fractures should be avoided in favor of early definitive MN when possible. If temporization is needed, TPF may be a better option than ex-fix.

Indexed as

Bone PlatesTibial FracturesAdultAgedExternal FixatorsFemaleFracture FixationFracture Fixation, IntramedullaryFracture HealingFractures, UnunitedHumansMaleMiddle AgedRetrospective StudiesTreatment Outcomeexternal fixationopen fractureoutcomestemporary plate fixationtibia fracture

Identifiers

PMID38919353
PMCPMC11195873

What OpenQuestion holds

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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.