Evidence map›Paper›PMID 41359279›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025

There is no difference in prevalence of rotation malalignment following intramedullary nailing of open versus closed tibial shaft fractures.

Megan E Cain, Dagmar S Alderlieste, Nynke van der Gaast, Joy Verbakel, Britt Edwards, Emily H Jaarsma, Laurent A M Hendrickx, Frank F A IJpma, Erik Hermans, Michael J R Edwards and 2 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 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

12 authors.

Megan E CainDepartment of Orthopaedics and Trauma Surgery, Flinders Medical Centre, Bedford Park, Australia. drmegancain@gmail.com.
Dagmar S AlderliesteDepartment of Orthopaedics and Trauma Surgery, Flinders Medical Centre, Bedford Park, Australia.
Nynke van der GaastDepartment of Orthopaedics and Trauma Surgery, Flinders Medical Centre, Bedford Park, Australia.
Joy VerbakelDepartment of Orthopaedics and Trauma Surgery, Flinders Medical Centre, Bedford Park, Australia.
Britt EdwardsDepartment of Orthopaedics and Trauma Surgery, Flinders Medical Centre, Bedford Park, Australia.
Emily H JaarsmaDepartment of Orthopaedics and Trauma Surgery, Flinders Medical Centre, Bedford Park, Australia.
Laurent A M HendrickxDepartment of Orthopaedics and Trauma Surgery, Flinders Medical Centre, Bedford Park, Australia.
Frank F A IJpmaDepartment of Orthopaedic Surgery, University Medical Center Groningen, Groningen, The Netherlands.
Erik HermansDepartment of Trauma Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Michael J R EdwardsDepartment of Trauma Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Job N DoornbergDepartment of Orthopaedic Surgery, University Medical Center Groningen, Groningen, The Netherlands.
Ruurd L JaarsmaDepartment of Orthopaedics and Trauma Surgery, Flinders Medical Centre, Bedford Park, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTibial shaft fractures are the most prevalent long-bone fracture and often associated with high energy mechanisms. As a result, 12-15% are seen to been open fractures making up 45% of open fractures. Open fractures are commonly associated with higher complication rates such as infection, and non-union. Intramedullary nails (IMN) are an accepted treatment modality open tibial shaft fractures; however, IMNs are known to be associated with potential rotational malalignment. We hypothesis that an open tibial shaft fracture may in fact be protective against post operative rotational malalignment (RM) given the direct visualisation.

methodsThis retrospective study included 268 consecutive patients with a unilateral tibial shaft fracture treated with in IMN between January 2009 and April 2023 within a single level 1 trauma centre. All patients underwent a post-operative bilateral CT for assessment of rotational alignment.

resultsRM was observed in 32.8% and 34.4% of patients with closed and open fractures respectively. Indicating no significant difference in the prevalence of RM between fracture groups (p = 0.82). Furthermore, there was no significant difference in the distribution (p = 0.82) and direction of RM (p = 0.11) between the groups. In the closed fracture group left sided fracture led to predominately internal RM whilst nailing of right sided tibial shaft fractures resulted in predominately external RM, this was not re-produced in the open fracture group.

conclusionsThe prevalence of RM was not influenced by whether the fracture was open or closed. Hence the choice of surgical approach should rely on factors other than the risk of RM. LEVEL OF EVIDENCE: Level III.

Indexed as

Bone MalalignmentFracture Fixation, IntramedullaryFractures, ClosedFractures, OpenPostoperative ComplicationsTibial FracturesAdultAgedBone NailsFemaleHumansMaleMiddle AgedPrevalenceRetrospective StudiesRotationCompound fractureMalrotationOpen fractureTibial shaft fracture

Identifiers

PMID41359279

What OpenQuestion holds

Textmetadata
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.