Prediction of tibial nonunion at the 6-week time point

Injury
Keir A RossRobert V O'Toole

Abstract

Intramedullary (IM) nail fixation is a common operative treatment, yet concerns regarding the frequency of complications, such as nonunion, remain. Treatment of tibial shaft fractures remains a challenge, and little evidence of prognostic factors that increase risk of nonunion is available. The aim of this study was to develop a predictive model of tibial shaft fracture nonunion 6 weeks after reamed intramedullary (IM) nail fixation based on commonly collected clinical variables and the radiographic union score for tibial fractures (RUST). A retrospective case-control study was conducted. All tibial shaft fractures treated at our level I trauma center from 2007 to 2014 were retrospectively reviewed. Only patients with follow-up until fracture healing or secondary operation for nonunion were included. Fracture gaps ≥3 mm were excluded. A total of 323 patients were included for study. Infection within 6 weeks of operation, standard RUST, and the Nonunion Risk Determination (NURD) score had statistically significant associations with nonunion (odds ratio > or < 1.0; p < 0.01). The NURD score was increasingly predictive of nonunion with decreasing RUST. All patients in the high RUST group (RUST ≥ 10), achieved union regardless of N...Continue Reading

Citations

Feb 9, 2020·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Anthony V ChristianoKenneth A Egol
Apr 23, 2020·Current Osteoporosis Reports·G Bradley ReahlMichael Kain
Mar 28, 2020·Current Osteoporosis Reports·Peter SchwarzenbergHannah L Dailey
Sep 5, 2020·Journal of Orthopaedic Surgery and Research·Ruifeng TianLiangman Li
Aug 17, 2020·JBJS Reviews·Justin E HellwinkelZachary M Working
Jan 28, 2020·Injury·Yousif Atwan, Emil H Schemitsch
Mar 23, 2020·OTA International : the Open Access Journal of Orthopaedic Trauma·Yousif Atwan, Emil H Schemitsch
Jul 29, 2020·Injury·George D ChlorosPeter V Giannoudis
Jun 17, 2021·International Orthopaedics·George D ChlorosPeter V Giannoudis
Aug 7, 2021·Nature Reviews. Disease Primers·Britt WildemannJesse B Jupiter
Sep 25, 2021·Biomarkers : Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals·Joseph R ChitwoodRoman M Natoli
Sep 29, 2021·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Shuhei HiyamaKatsushi Takeshita
May 4, 2021·Journal of Orthopaedic Trauma·Robert D WojahnChristopher M McAndrew

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