What question did this study set out to answer?

To evaluate whether fellowship-trained orthopaedic trauma surgeons achieve better postoperative radiographic parameters than non-trauma-trained community surgeons when treating intertrochanteric femur fractures with intramedullary nails.

June 5, 2023Journal of the American Academy of Orthopaedic Surgeons

Fellowship-Trained Orthopaedic Trauma Surgeons Achieve Better Postoperative Radiographic Parameters After Intramedullary Nailing of Intertrochanteric Femur Fractures when Compared With Non-trauma–Trained Surgeons

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Intertrochanteric femur fractures (n=200). Intervention: Treatment by fellowship-trained orthopaedic trauma surgeons vs. Treatment by community surgeons. Primary outcome: Good reduction quality (p=<0.001).

View Full Paper

Ask AI

Bookmark

Key result

Treatment of intertrochanteric femur fractures by fellowship-trained orthopaedic trauma surgeons yielded significantly more good reductions (93% vs 19%, P<0.001) compared to community surgeons.

Why the study?

Because many factors predictive of failure are related to technical aspects of surgery, the study aimed to compare postoperative radiographic parameters between fellowship-trained orthopaedic trauma surgeons and non-trauma-trained surgeons.

Does treatment by fellowship-trained orthopaedic trauma surgeons improve postoperative radiographic parameters in patients with intertrochanteric femur fractures compared to community surgeons?

Comparison

Fellowship-trained orthopaedic trauma surgeons vs non-trauma-trained community surgeons

Design

Retrospective cohort study

Authors

MSM. Kareem ShaathFlorida State University JYJonathan P. YawmanFlorida State University TATyler AndersonWestern Michigan University

Discussion

Member takes

Implication

Fellowship-trained trauma surgeons linked to superior radiographic parameters in intertrochanteric nailing; supports emphasis on technical training but leaves open effects on clinical outcomes.

Key Points

To evaluate whether fellowship-trained orthopaedic trauma surgeons achieve better postoperative radiographic parameters than non-trauma-trained community surgeons when treating intertrochanteric femur fractures with intramedullary nails.
Retrospective comparative study of 200 consecutive patients undergoing intramedullary nailing (CPT 27245) across a single hospital network.
Patients were stratified into two cohorts based on surgeon background: fellowship-trained orthopaedic traumatologists (n=100 across 5 surgeons) versus community orthopaedic surgeons (n=100).
Evaluated radiographic parameters included postoperative neck-shaft angle (NSA), NSA difference compared with the uninjured limb, tip-apex distance (TAD), and reduction quality.
Trauma-trained surgeons achieved a significantly lower mean tip-apex distance compared with community surgeons (10 mm vs 21 mm; P < 0.001).
Mean postoperative neck-shaft angle was 133° in the trauma group versus 127° in the community group (P < 0.001), with limb differences averaging 2.5° valgus versus 5° varus, respectively (P < 0.001).
Good reductions were achieved in 93 trauma patients versus 19 community patients (P < 0.001), while poor reductions occurred in 0 trauma patients compared with 49 community patients (P < 0.001).

Study Design

Type

Cohort (n=200)

Multicenter

Yes

Structured PICO

Does treatment by fellowship-trained orthopaedic trauma surgeons improve postoperative radiographic parameters in patients with intertrochanteric femur fractures compared to community surgeons?

Population

200 consecutive patients with intertrochanteric femur fractures treated with intramedullary nails by either fellowship-trained orthopaedic traumatologists or community surgeons.

Exposure

Surgery performed by fellowship-trained orthopaedic trauma surgeons

Comparator

Surgery performed by community surgeons (non-trauma-trained)

Outcome

Neck-shaft angle (NSA), comparison of the repaired NSA with the uninjured side, tip-apex distance, and reduction qualitysurrogate

Main Result

Absolute Event Rate: 93% vs 19%

p-value: p=<0.001

Fellowship-trained orthopaedic trauma surgeons achieve significantly better postoperative radiographic parameters and reduction quality when treating intertrochanteric femur fractures compared to non-trauma-trained community surgeons.

Cite This Study

Shaath et al. (2023) conducted a cohort in Intertrochanteric femur fractures (n=200). Treatment by fellowship-trained orthopaedic trauma surgeons vs. Treatment by community surgeons was evaluated on Good reduction quality (p=<0.001). Treatment of intertrochanteric femur fractures by fellowship-trained orthopaedic trauma surgeons yielded significantly more good reductions (93% vs 19%, P<0.001) compared to community surgeons.

synapsesocial.com/papers/6a86ffc43a1d8ec5fdd3d526 https://doi.org/10.5435/jaaos-d-22-00877

View Full Paper

Ask AI

Bookmark

Implication

Fellowship-trained trauma surgeons linked to superior radiographic parameters in intertrochanteric nailing; supports emphasis on technical training but leaves open effects on clinical outcomes.

Fellowship-Trained Orthopaedic Trauma Surgeons Achieve Better Postoperative Radiographic Parameters After Intramedullary Nailing of Intertrochanteric Femur Fractures when Compared With Non-trauma–Trained Surgeons

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Fellowship-Trained Orthopaedic Trauma Surgeons Achieve Better Postoperative Radiographic Parameters After Intramedullary Nailing of Intertrochanteric Femur Fractures when Compared With Non-trauma–Trained Surgeons

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider