Evidence map›Paper›PMID 39794605›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025

Mobility and living status at discharge and after three-months for extramedullary versus intramedullary fixation of AO type 31-A1 trochanteric fractures; an analysis of Dutch hip fracture audit data.

Miliaan L Zeelenberg, Esther M M Van Lieshout, Taco Gosens, Johannes H Hegeman, Dennis Den Hartog, Michael H J Verhofstad, Stable-HIP group, Pieter Joosse, Rudolf W Poolman, Hanna C Willems and 11 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. 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

21 authors.

Miliaan L ZeelenbergTrauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
Esther M M Van LieshoutTrauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. e.vanlieshout@erasmusmc.nl.
Taco GosensDepartment of Orthopedics, Elisabeth Hospital (ETZ), Tilburg, The Netherlands.
Johannes H HegemanDepartment of Trauma Surgery, Ziekenhuisgroep Twente, Almelo, The Netherlands.
Dennis Den HartogTrauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
Michael H J VerhofstadTrauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
Stable-HIP group
Pieter Joosse
Rudolf W Poolman
Hanna C Willems
Rutger G Zuurmond
Dutch Hip Fracture Audit indicator Taskforce
G De Klerk
O C Geraghty
H A F Luning
A H P Niggebrugge
M Regtuijt
J Snoek
C Stevens
D Van der Velde
E J M M Verleisdonk

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe use of intramedullary fixation of AO type 31-A1 fractures is rising, despite evidence of non-superiority when compared with extramedullary fixation. The aim of this study was to evaluate mobility and living status for extramedullary fixation (EMF) versus intramedullary fixation (IMF) in Dutch hospitals during the initial hospital stay and until three-months after trauma.

methodsData on patient characteristics, mobility, living status, complications, reoperation, and mortality were extracted from the Dutch Hip Fracture Audit Indicator Taskforce. Data were collected for patients (> 65 years) at baseline, at discharge, and at three-months follow-up. Univariate analysis was used for comparing the EMF versus IMF group.

resultsA total of 836 patients were included; 138 (16%) were treated with EMF and 698 (84%) with IMF. No significant differences were found between groups for the overall complication rate during the initial hospital stay (EMF: n = 55 (40%) versus IMF: n = 270 (39%)). Patients treated with EMF showed better mobility at discharge (mobility with frame/2 supports or better, EMF 77% versus IMF 50%), but otherwise no significant difference was found after a three-month follow-up (EMF 80% versus IMF 82%), suggesting faster improved mobility for IMF. However, matched subgroup analysis showed no meaningful differences in rates of deteriorated mobility or living status after three months.

conclusionThis study showed no meaningful differences between EMF and IMF of type 31-A1 trochanteric fractures during hospital stay and until three-month follow-up. Despite little differences in outcome and EMF being the treatment option of first choice by the Dutch Hip fracture guideline, IMF is used in the vast majority of patients.

Indexed as

Fracture Fixation, InternalFracture Fixation, IntramedullaryHip FracturesAgedAged, 80 and overFemaleHumansLength of StayMaleMedical AuditNetherlandsPatient DischargePostoperative ComplicationsTreatment OutcomeAO type 31-A1Dutch hip fracture auditExtramedullary fixationIntramedullary fixationTrochanteric fracture

Identifiers

PMID39794605
PMCPMC11723844

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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.