Evidence map›Paper›PMID 40443565›Full record

ArticleOTA international : the open access journal of orthopaedic trauma2025

How does internal fixation compared with arthroplasty affect quality of life for patients who have suffered femoral neck fractures?

Zafar Ahmad, Daniel Axelrod, Marianne Comeau-Gauthier, Sofia Bzovsky, Rudolf W Poolman, Frede Frihagen, Mohit Bhandari, Marc Swiontkowski, Sheila Sprague, Emil Schemitsch

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In one paragraph

Article in OTA international : the open access journal of orthopaedic trauma, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Zafar AhmadDepartment of Surgery, Western University, London, ON, Canada.
Daniel AxelrodDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Marianne Comeau-GauthierDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Sofia BzovskyDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Rudolf W PoolmanDepartment of Orthopedic Surgery, OLVG, Amsterdam and LUMC, Leiden, the Netherlands.
Frede FrihagenDepartment of Orthopaedic Surgery, Østfold Hospital Trust, Grålum, Norway.
Mohit BhandariDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Marc SwiontkowskiDepartment of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN.
Sheila SpragueDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Emil SchemitschDepartment of Surgery, Western University, London, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: To evaluate functional outcomes amongst femoral neck fracture trial participants who did not undergo reoperation. Design: Secondary analysis of 2 randomized controlled trials. Setting: Ninety hospitals in 5 continents. Participants: Patients aged 50 years or older with a femoral neck fracture. Intervention: Arthroplasty, including total hip arthroplasty and hemiarthroplasty, or internal fixation, including sliding hip screw or multiple cancellous screws. Main Outcome Measurement: The Western Ontario and McMaster University Arthritis Index (WOMAC) and 12-item Short Form Health Survey (SF-12) physical component summary (PCS). Results: Data from 716 arthroplasty patients and 549 internal fixation patients were included in our propensity score weighting model. Internal fixation patients had higher WOMAC stiffness scores (leading to poorer function) at 24 months postoperatively compared with total hip arthroplasty patients (adjusted mean difference [AMD] 0.42 points, 99% confidence interval [CI] 0.09-0.75; Conclusion: While stiffness is worse following internal fixation, our results show similar functional outcomes in femoral neck fracture patients undergoing modern methods of internal fixation versus arthroplasty. These results, however, may not be applicable to a younger, more active hip fracture population. Level of Evidence: Prognostic Level II.

Indexed as

arthroplastyfemoral neck fracturesinternal fixationquality of life

Identifiers

PMID40443565
PMCPMC12122168

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.