Risk factors of non-union in intramedullary stabilized diaphyseal long bone fractures: identifying the role of fracture stabilization strategies and concomitant injuries.
Chest injury
DCO
ETC
Non-union
TBI
Treatment strategy
Journal
European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
05
11
2019
accepted:
18
02
2020
pubmed:
7
3
2020
medline:
15
12
2021
entrez:
7
3
2020
Statut:
ppublish
Résumé
Concomitant chest injury is known to negatively affect bone metabolism and fracture healing, whereas traumatic brain injury (TBI) appears to have positive effects on bone metabolism. Osteogenesis can also be influenced by the timing of fracture stabilization. We aimed to identify how chest injuries, TBI and fracture stabilization strategy influences the incidence of non-union. Patients with long bone fractures of the lower extremities who had been treated between 2004 and 2014 were retrospectively analysed. Non-union was defined as fracture healing not occurring in the expected time period and in which neither progression of healing nor successful union is expected without intervention. Diverse clinical and radiological parameters were statistically analysed using the Statistical Package for the Social Sciences (SPSS). The total number of operations before consolidation was an independent predictor (odds ratio [OR] = 6.416, p < 0.001) for the development of non-union in patients with long bone fractures. More specifically, patients treated according to the damage control orthopaedics (DCO) principle had a significantly higher risk of developing a non-union than patients treated according to the early total care (ETC) principle (OR = 7.878, p = 0.005). Concomitant chest injury and TBI could not be identified as influencing factors for non-union development. Our results indicate that the number of operations performed in patients with long bone fractures should be kept as low as possible and that the indication for and the timing of DCO treatment should be meticulously noted to minimize the risk of non-union development.
Identifiants
pubmed: 32140749
doi: 10.1007/s00068-020-01335-y
pii: 10.1007/s00068-020-01335-y
pmc: PMC8629802
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1903-1910Informations de copyright
© 2020. The Author(s).
Références
J Orthop Res. 2011 May;29(5):734-9
pubmed: 21437953
Injury. 2007 Sep;38 Suppl 4:S3-6
pubmed: 18224731
J Bone Joint Surg Br. 1997 May;79(3):433-7
pubmed: 9180323
J Bone Joint Surg Am. 2009 Feb;91(2):282-8
pubmed: 19181971
Injury. 2005 Mar;36(3):363-8
pubmed: 15710151
J Bone Joint Surg Br. 2012 Feb;94(2):227-30
pubmed: 22323691
J Endocrinol Invest. 1998 Feb;21(2):78-86
pubmed: 9585380
Injury. 2006 Sep;37 Suppl 3:S18-24
pubmed: 16963358
J Bone Joint Surg Br. 1987 Aug;69(4):525-8
pubmed: 3611151
Zentralbl Chir. 2003 Aug;128(8):674-9
pubmed: 12931264
Eur Rev Med Pharmacol Sci. 2017 Apr;21(7):1522-1531
pubmed: 28429354
J Trauma. 2005 Dec;59(6):1375-94; discussion 1394-5
pubmed: 16394911
Injury. 2007 May;38 Suppl 2:S3-9
pubmed: 17920415
PLoS One. 2015 Jul 06;10(7):e0131194
pubmed: 26147725
Lancet. 1974 Jul 13;2(7872):81-4
pubmed: 4136544
Med Princ Pract. 2016;25(4):336-42
pubmed: 26954461
J Orthop Trauma. 2016 Mar;30(3):104-12
pubmed: 26606600
Injury. 2015 Jan;46(1):1-3
pubmed: 25540874
J Trauma. 1974 Mar;14(3):187-96
pubmed: 4814394
Injury. 2015 Aug;46(8):1601-7
pubmed: 26026201
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
Injury. 2014 Oct;45(10):1653-8
pubmed: 25062602
Injury. 2011 Jun;42(6):549-50
pubmed: 21474131
Mediators Inflamm. 2015;2015:204842
pubmed: 25873754
Chirurg. 1999 Nov;70(11):1287-93
pubmed: 10591766