Evidence map›Paper›PMID 30627473›Full record

ArticleGeriatric orthopaedic surgery & rehabilitation2018

Outcomes for Elderly Patients With Atypical Femoral Fractures Compared to Typical Femoral Fractures for Length of Stay, Discharge Destination, and 30-Day Mortality Rate.

Dominic Davenport, James Duncan, Robert Duncan, Alastair Dick, Mohit Bansal, Max R Edwards

Open access · goldAbstract read
In one paragraph

Article in Geriatric orthopaedic surgery & rehabilitation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 23% of its field
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

3 citing papers in PubMed, 7 citations in OpenAlex.

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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

6 authors at 2 institutions in 1 country.

Dominic DavenportDepartment of Trauma and Orthopaedics, King's College Hospital NHS Foundation Trust, Princess Royal University Hospital, London, United Kingdom.
James DuncanDepartment of Trauma and Orthopaedics, King's College Hospital NHS Foundation Trust, Princess Royal University Hospital, London, United Kingdom.
Robert DuncanUniversity of Birmingham Medical School, Birmingham, United Kingdom.
Alastair DickDepartment of Trauma and Orthopaedics, King's College Hospital NHS Foundation Trust, Princess Royal University Hospital, London, United Kingdom.ORCID https://orcid.org/0000-0002-3968-4193
Mohit BansalDepartment of Trauma and Orthopaedics, King's College Hospital NHS Foundation Trust, Princess Royal University Hospital, London, United Kingdom.
Max R EdwardsDepartment of Trauma and Orthopaedics, King's College Hospital NHS Foundation Trust, Princess Royal University Hospital, London, United Kingdom.
Princess Royal University Hospital · GBUniversity of Birmingham · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDespite increasing recognition of atypical femoral fractures (AFFs), there's conflicting evidence about incidence, aetiology, and short-term outcomes of these injuries. This study reports the incidence of AFFs at our center and compares the early postoperative outcomes against typical femoral fractures (TFFs).

methodsA retrospective observational cohort study of patients presenting to our trauma unit between November 2015 and July 2016 was undertaken. Inclusion criteria required radiologically confirmed proximal femoral fracture, which was then categorized as AFF or TFF. Primary outcome measures included length of stay, discharge destination, and 30-day mortality.

resultsTwo hundred thirty-nine patients presented to our trauma unit over 9 months with either a fractured neck of femur or proximal femoral fracture. A total of 122 were identified as pertrochanteric, subtrochanteric, or proximal femoral shaft fractures of which 25 (20.5%) displayed atypical radiographic features consistent with AFF. The 2 groups were similar for average age (TFF 85.3 years vs AFF 85.0 years), gender (19% vs 16% male gender), American Society of Anaesthesiology grade (3.0 vs 3.0), cognitive score (abbreviated mental test score = 7.03 vs 7.08), and preinjury place of residence (88.9% vs 92.0% lived in own home). Typical fractures were fixed with either dynamic hip screw or intramedullary nailing, all atypical fractures were fixed with intramedullary nailing. There was no statistical difference between the 2 groups for length of stay (12.8 days vs 14.3 days; DISCUSSION: In our predominantly geriatric population atypical radiographic features were observed in around 10% of patients presenting with proximal femoral fractures or fractured neck of femur. Previous studies have reported poor outcomes for pain, mobility, and length of stay after AFF. However, we observed no difference in short-term outcome measures when compared to patients with typical proximal femoral fracture patterns at our trauma unit.

conclusionWith modern principles of trauma care outcomes achieved following AFFs may be equivalent to typical femoral fractures in the geriatric population.

Indexed as

atypical fracturesbisphosphonatesfragility fracturesgeriatric traumaosteoporosistrauma surgery

Identifiers

PMID30627473
PMCPMC6311535
OpenAlexW2907018108

What Socratic holds

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LicenceCC BY-NC
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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 Socratic graph.