PubMed 3 - Display Options - Infected Non-union of the Tibia

This is the third in a series of mini-workshops on the subject of using PubMed to undertake orthopaedic literature searches. We will use the subject of infected non-unions of the tibia.

Open PubMed and enter the search string infected non-union tibia and run the search. This search produces a surprisingly small number of papers (26). As we learned in the previous workshop the best response to an unexpected search result is to look up Details to see how the search was translated.

Query Translation:

The Translation does not show any real surprises but does explain why we didn't get a very long list. It is significant that "non-union" and "infected" are not MeSH terms and do not get translated into MeSH terms. This means that if the article refers to other synonyms (nonunion; osteomyelitis) it will not be found. In a later workshop we will look at ways to find the appropriate MeSH terms to ensure that your search is comprehensive. For the present purpose we will do what we did in the first workshop and find a good looking article the use the related articles link

From the list below I selected #6 and looked at the abstract

Items 1 - 20 of 26

1: Joshi D, Ahmed A, Krishna L, Lal Y. Related Articles, Links
Unreamed interlocking nailing in open fractures of tibia.
J Orthop Surg (Hong Kong). 2004 Dec;12(2):216-21.
PMID: 15621910 [PubMed - in process]
2: Reed AA, Joyner CJ, Brownlow HC, Simpson AH. Related Articles, Links
Human atrophic fracture non-unions are not avascular.
J Orthop Res. 2002 May;20(3):593-9.
PMID: 12038636 [PubMed - indexed for MEDLINE]
3: Thirumal M, Shong HK. Related Articles, Links
Bone transport in the management of fractures of the tibia.
Med J Malaysia. 2001 Mar;56(1):44-52.
PMID: 11503296 [PubMed - indexed for MEDLINE]
4: Aik S, Sengupta S. Related Articles, Links
Limb reconstruction surgery with external fixators--university hospital experience.
Med J Malaysia. 2000 Sep;55 Suppl C:86-92.
PMID: 11200049 [PubMed - indexed for MEDLINE]
5: Musharafieh R, Osmani O, Musharafieh U, Saghieh S, Atiyeh B. Related Articles, Links
Efficacy of microsurgical free-tissue transfer in chronic osteomyelitis of the leg and foot: review of 22 cases.
J Reconstr Microsurg. 1999 May;15(4):239-44. Review.
PMID: 10363546 [PubMed - indexed for MEDLINE]
6: Hosny G, Shawky MS. Related Articles, Links
The treatment of infected non-union of the tibia by compression-distraction techniques using the Ilizarov external fixator.
Int Orthop. 1998;22(5):298-302.

PMID: 9914932 [PubMed - indexed for MEDLINE]
7: Song HR, Cho SH, Koo KH, Jeong ST, Park YJ, Ko JH. Related Articles, Links
Tibial bone defects treated by internal bone transport using the Ilizarov method.
Int Orthop. 1998;22(5):293-7.
PMID: 9914931 [PubMed - indexed for MEDLINE]
8: Kocialkowski A, Marsh DR, Shackley DC. Related Articles, Links
Closure of the skin defect overlying infected non-union by skin traction.
Br J Plast Surg. 1998 Jun;51(4):307-10.
PMID: 9771349 [PubMed - indexed for MEDLINE]
9: Saleh M, Kreibich DN, Ribbans WJ. Related Articles, Links
Circular frames in the management of infected tibial non-union: a modification of the Papineau technique.
Injury. 1996 Jan;27(1):31-3.
PMID: 8746313 [PubMed - indexed for MEDLINE]

The abstract confirms that this article is right on subject.
You may have noticed that there is a collection of pull-down menu boxes above the text. .   eg. Display  In the workshop the menu boxes will display their options but are inactive. On the site, if you select a different option in the display pull-down menu box you will get a different display.

Display  Show 

All: 1 

Review: 0 

1: Int Orthop. 1998;22(5):298-302. Related Articles, Links
The treatment of infected non-union of the tibia by compression-distraction techniques using the Ilizarov external fixator.

Hosny G, Shawky MS.

Department of Orthopaedic Surgery, Benha Faculty of Medicine, Tanta El Gharbia, Egypt.

Circular external fixation using the Ilizarov apparatus combined with compression-distraction techniques was used to treat 11 patients with infected non-union and segmental bone loss of the tibia. The series comprised 8 males and 3 females, with an average age of 27 years (range 17-51 years). The average number of previous failed surgical attempts at union was 2 per patient (range 1 to 4). Three infected non-unions without shortening were treated with complete resection of the site and conversion of the diaphysis into a segmental defect. The functional results were excellent in 5, good in 3, fair in 2 and poor in one patient. No additional procedures were used in any of the patients.
To see how this article was classified use the pull-down menu box to change the display to Citation

The abstract will be displayed again but this time the subject classification is shown below the text, as MeSH terms. We note that Fractures, Ununited is the MeSH term for non-union and that Infection is the MeSH term, not infected. So that is why our search string was not comprehensive. If you wish to be distracted, the most comprehensive search string for infected non union of the tibia is infection "fractures,ununited" tibia

MeSH Terms:

  • Adolescent
  • Adult
  • Female
  • Fracture Fixation/methods*
  • Fractures, Ununited/surgery*
  • Humans
  • Ilizarov Technique/instrumentation*
  • Infection/surgery*
  • Male
  • Middle Aged
  • Reoperation
  • Tibial Fractures/surgery*
  • Treatment Outcome

Click on the Related Articles link for Hosney & Shawky 1998 This yields 237 articles and we can see that many of them spell non-union nonunion. Although this collection is not comprehensive on the subject of infected non-unions of the tibia it is suitable for our purposes. We are going to see how using the display controls can make it easier to winnow out desirable papers from a long list. For the purposes of this exercise we are going to make a reading list of papers that about Ilizarov techniques for management of infected tibial non-unions. To do this we need to select them out of the list produced by PubMed and create our own list. There are several functions to help us do this including a clipboard with a capacity of 500 citations. We are going to select out relevant articles and copy them to the clipboard prior to displaying the full abstracts.

  1. Open the pull down menu for "Show" and select 500. This control tells the site how many citations you want to see on one page. It is an advantage to have all the citations on the same page.
  2. Open the edit menu of your browser and select "Find"
  3. Type in "Ilizarov" and click on Find Next

    The browser will advance to the first occurence of the word Ilizarov in the citation list and highlight it.
  4. If the article is (or might be) on infected non-union of the tibia treated by the Ilizarov method check the checkbox beside the authors. In the example below articles 1 & 3 were selected because the title indicated they were about Ilizarov treatment of infected non-union. Article 2 appears to be about treatment of the acute injury.
    1: Hosny G, Shawky MS. Related Articles, Links
    The treatment of infected non-union of the tibia by compression-distraction techniques using the Ilizarov external fixator.
    Int Orthop. 1998;22(5):298-302.
    PMID: 9914932 [PubMed - indexed for MEDLINE]
    2: Sen C, Kocaoglu M, Eralp L, Gulsen M, Cinar M. Related Articles, Links
    Bifocal compression-distraction in the acute treatment of grade III open tibia fractures with bone and soft-tissue loss: a report of 24 cases.
    J Orthop Trauma. 2004 Mar;18(3):150-7.
    PMID: 15091269 [PubMed - indexed for MEDLINE]
    3: Cattaneo R, Catagni M, Johnson EE. Related Articles, Links
    The treatment of infected nonunions and segmental defects of the tibia by the methods of Ilizarov.
    Clin Orthop Relat Res. 1992 Jul;(280):143-52.
    PMID: 1611734 [PubMed - indexed for MEDLINE]
  5. Repeat the "Find Next" and selection steps (3 and 4) until you have gone through the whole list. You can do this by scrolling down but this way is much faster.
  6. When you have finished click on the "Send To" menu box which can be found at either the top or bottom of the page. Select Clipboard

    The page re-loads. You will note some lines near the top which states how many citations were placed on the clipboard.
    41 items were added to Clipboard.
    Clipboard items will be lost after eight hours of inactivity.
    The maximum number of Clipboard items is 500.
  7. For the obsessive repeat steps 3-6 using the term "fixator" in case the word Ilizarov was not used
  8. Open the Clipboard by clicking on the clipboard tab at the top of the page

    All the articles sent to the clipboard are now displayed in the default (Summary) format.
  9. Change the display to Abstract

    The complete abstract is now displayed for all the items on the clipboard (make sure the "show" menu has been adjected to display enough articles). If you are comfortable saving this as an html file you can do this using File/Save As on your browser. This will have the advantage that all the links (eg to related articles) will be preserved. The disadvantage is that some of the javascript instructions may not work and you may have to save a number of small Icons and logos for the page to load correctly. Don't expect the page you save to behave exactly like the site.
  10. Send to text

  11. Save text. This text is saved on the Orthogate server as there was not enough room to put on this message.

One further display control which you may find helpful is really a filter. If you select the "Review" button the only articles from the current list which will be displayed are those characterised by the librarians as reviews. In this instance this is not a particularly helpful thing to do.


The display controls for PubMed are shown below. They are most useful when you are trying to select out a subset of articles from a longer list. The drop down menu boxes in this illustration are functional but they do not control PubMed functions in this workshop. You can try them out to see what options there are but don't expect any action

Display  Show 

All: 149 

Review: 6 

  1. The Display Control alters the way in which the article(s) are displayed. There is a large variety of display types. The ones found most useful are
  2. Show: this controls how many articles are shown on each page
  3. Sort by: this controls the order in which the articles are displayed. The initial sorting is by relevance and publication date. Sorting can be done by Publication Date, Author or Journal
  4. Send to: this control sends the page or selected items from the page to various destinations
  5. All button: This is the default setting. If you have previously selected the Review filter (see below) clicking on All will return you to the full list. The number of article in the full list is noted
  6. Review Button: This imposes a filter on the list. If you click it the only articles displayed are those classified as Review Articles. This could be a helpful way to cut down the list but often is not very rewarding. The number is the number of review articles in the list.

Please send any comments or discussion to the Orthopod Mailing List If you are not a member of the list you can join by sending a blank message to

Other workshops in this series

Myles Clough
July 2nd 2005