Evidence map›Paper›PMID 40392364›Full record

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

Outcome of femoral fractures treated with cerclages and intramedullary nailing.

Franziska Ziegenhain, Claudio Canal, Sascha Halvachizadeh, Anne Mittlmeier, Hans-Christoph Pape, Christian Hierholzer, Valentin Neuhaus

Registry-linked trialAbstract read
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. It is linked to trial NCT07434258 (Dose Response Association Between Cerclage Construct Count and Deep Infection After Femoral and Periprosthetic Femoral Fracture Fixation), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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.

NCT07434258 completednot on this map

Dose Response Association Between Cerclage Construct Count and Deep Infection After Femoral and Periprosthetic Femoral Fracture Fixation: A Dual-Center Retrospective Cohort Study

TypeobservationalSponsorIstanbul UniversityRan2015 to 2025Enrolled148ConditionsFemur Fracture, Periprosthetic Fracture of Hip, Periprosthetic Fracture of the Femur, Surgical Site Infection (SSI)Arms1 Metallic Cerclage Wiring, 2 metalic cerclage wire, 3 metalic cerclage wire
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Independent Risk Factors for Lag Screw Cut-Out: The Role of Open Reduction in Intertrochanteric Fracture Fixation With the Proximal Femoral Nail.Medical science monitor : international medical journal of experimental and clinical research · 2026
    Article
  3. Response to the letter to the editor: "Outcome of Femoral Fractures Treated with Cerclages and Intramedullary Nailing".European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026
    Article
  4. Letter to the Editor: "Outcome of femoral fractures treated with cerclages and intramedullary Nailing".European journal of trauma and emergency surgery : official publication of the European Trauma Society · 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.

Franziska ZiegenhainDivision of Trauma Surgery, University Hospital Zurich (USZ), University of Zurich (UZH), Raemistrasse 100, 8091, Zuerich, Switzerland. franziska.ziegenhain@usz.ch.
Claudio CanalDivision of Trauma Surgery, University Hospital Zurich (USZ), University of Zurich (UZH), Raemistrasse 100, 8091, Zuerich, Switzerland.
Sascha HalvachizadehDivision of Trauma Surgery, University Hospital Zurich (USZ), University of Zurich (UZH), Raemistrasse 100, 8091, Zuerich, Switzerland.
Anne MittlmeierDivision of Trauma Surgery, University Hospital Zurich (USZ), University of Zurich (UZH), Raemistrasse 100, 8091, Zuerich, Switzerland.
Hans-Christoph PapeDivision of Trauma Surgery, University Hospital Zurich (USZ), University of Zurich (UZH), Raemistrasse 100, 8091, Zuerich, Switzerland.
Christian HierholzerDivision of Trauma Surgery, University Hospital Zurich (USZ), University of Zurich (UZH), Raemistrasse 100, 8091, Zuerich, Switzerland.
Valentin NeuhausDivision of Trauma Surgery, University Hospital Zurich (USZ), University of Zurich (UZH), Raemistrasse 100, 8091, Zuerich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFemoral shaft fractures are a common entity in trauma surgery. The gold standard is closed reduction and intramedullary nailing. However, in some fracture patterns, the surgeon may choose to open the fracture for reduction. The purpose of this retrospective study was to analyze the outcome of femoral shaft fractures treated with open reduction, cerclage wiring and intramedullary nailing.

methodsWe included adult patients with femoral shaft fractures treated with open reduction, cerclage wiring and intramedullary nailing at a level 1 trauma center in Switzerland during an 11-year period. The data collection was conducted retrospectively. Patient characteristics including age, sex and existing comorbidities were analyzed. Detailed information regarding the fracture patterns and surgical procedures was recorded. Outcome measures included the rates of malunion and nonunion, the time required for union, incidence of surgical site infections, and the frequency of revision surgeries.

resultsWe included a total of 69 patients, comprising 48 males and 21 females with a mean age of 50 years. A majority suffered a high velocity trauma (67%). The most common fracture type was multifragmentary subtrochanteric fracture. Approximately 57% of the patients underwent definitive surgical care within the first 24 h. Number of cerclages applied ranged from 1 to 4, with 18% positioned above the lesser trochanter. Delayed union occurred in 10% of cases, while nonunion was noted in 19% of patients. Complications included femoral head necrosis in 3 (4%) patients, and surgical site infections were documented in 3 (4%) cases.

conclusionOur findings give rise to closed reduction and internal fixation as a treatment of choice of femoral shaft fractures. We suggest the use of ORIF combined with cerclages, if closed reduction cannot be sufficiently achieved. However, a risk-benefit ratio should be assessed to minimize the risk of a higher complication rate with the use of ORIF.

Indexed as

Bone WiresFemoral FracturesFracture Fixation, IntramedullaryOpen Fracture ReductionAdultAgedAged, 80 and overBone NailsFemaleFracture HealingHumansMaleMiddle AgedReoperationRetrospective StudiesSurgical Wound InfectionCerclageFemoral shaft fracturesIntramedullary nailingOutcome

Identifiers

PMID40392364
PMCPMC12092471

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LicenceCC BY
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Registered trials

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.