Evidence map›Paper›PMID 41792474›Full record

ArticleArchives of orthopaedic and trauma surgery2026

Retrospective study of mechanical complications after cephalomedullary nail implantation from 2019 to 2024 following per-, sub- or intertrochanteric femur fractures.

Alexander Blümke, Adaugo Okoro, Aditya Vadgaonkar, Daniel Kühlwein, João Pinheiro, Maximilian Mellinghoff, Frederic Bludau, Andreas Schilder, Svetlana Hetjens, Michael Hackl and 2 more

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Article in Archives of orthopaedic and trauma surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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

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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

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5 · Who and what money

Authors and funding

12 authors.

Alexander BlümkeDepartment of Orthopedics and Trauma Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. alexander.bluemke@umm.de.
Adaugo OkoroDepartment of Orthopedics and Trauma Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Aditya VadgaonkarDepartment of Orthopedics and Trauma Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Daniel KühlweinDepartment of Orthopedics and Trauma Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
João PinheiroDepartment of Orthopedics and Trauma Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Maximilian MellinghoffDepartment of Orthopedics and Trauma Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Frederic BludauDepartment of Orthopedics and Trauma Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Andreas SchilderDepartment of Orthopedics and Trauma Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Svetlana HetjensMedical Faculty Mannheim, Heidelberg University, Department of Medical Statistics and Biomathematics, Mannheim, Germany.
Michael HacklDepartment of Orthopedics and Trauma Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Sascha GraviusDepartment of Orthopedics and Trauma Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Ali DarwichDepartment of Orthopedics and Trauma Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCephalomedullary nail (CMN) fixation is commonly used to treat extracapsular femoral fractures but is associated with mechanical complications, including implant cut-out, cut-in, and material failure. Identifying clinical and radiographic predictors of these complications is critical for improving patient outcomes.

methodsThis retrospective cohort study analyzed 401 patients treated with CMN for per-, sub-, or intertrochanteric fractures between 2019 and 2024. Clinical, laboratory, and radiographic parameters were evaluated using logistic regression analyses to identify predictors of mechanical complications.

resultsMechanical complications occurred in 7% (n = 28) of patients. The most common complications were cut-out (n = 16, 57%) and cut-in (n = 7, 25%). Significant predictors included increased tip-apex distance (TAD), younger patient age, and the requirement for postoperative blood transfusions. A TAD greater than 37.2 mm substantially elevated the risk of complications.

conclusionMechanical complications after CMN implantation can be significantly reduced by precise implant placement to minimize TAD and careful perioperative management of hemoglobin levels. Implementing these findings into clinical practice can potentially improve surgical outcomes and reduce patient morbidity.

Indexed as

Bone NailsFracture Fixation, IntramedullaryHip FracturesPostoperative ComplicationsAgedAged, 80 and overFemaleHumansMaleMiddle AgedProximal Femoral FracturesRetrospective StudiesCephalomedullary nailingElderly patientsHemoglobinOsteoporosisper-, sub- and intertrochanteric femur fracturesTip-apex distance

Identifiers

PMID41792474
PMCPMC12966185

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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.