Non-Union Scoring System (NUSS): Is It Enough in Clinical Practice?

Bone defect Fracture NUSS Non-Union Scoring System Non-union

Journal

Indian journal of orthopaedics
ISSN: 0019-5413
Titre abrégé: Indian J Orthop
Pays: Switzerland
ID NLM: 0137736

Informations de publication

Date de publication:
Jan 2023
Historique:
received: 04 07 2022
accepted: 18 10 2022
entrez: 19 1 2023
pubmed: 20 1 2023
medline: 20 1 2023
Statut: epublish

Résumé

Bone consolidation defects represent a real orthopedic challenge because of the absence of validated treatment guidelines that can assist the surgeon in his choices. The aim of this study is to evaluate the appropriateness of the Non-Union Scoring System NUSS treatment protocol in the management of long bone non-unions by comparing it to the experience-based therapeutic approach carried out in our facility. We conducted a comparative outcome study of a retrospective series of 89 patients surgically treated for long bone non-union in our facility vs. clinical results reported by Calori et al. obtained following the NUSS treatment protocol. Radiographic healing was reached in 13/13 non-unions (100%) in group NUSS 1, in 58/62 (93.5%) in group NUSS 2, and in 13/14 (92.9%) in group NUSS 3. The mean time to radiographic healing was 5.69 ± 2.09 months in group 1, 7.38 ± 3.81 months in group 2 and 9.23 ± 2.31 months in group 3. 91% of patients in group I, 69% in group II and 48% in group III received what would be considered by the NUSS treatment protocol an "overtreatment", especially from a biological stand point. The comparative outcome analysis shows that our case series achieved significantly higher global healing rates ( From the results obtained, we can assume that the NUSS treatment protocol might underestimate the necessary therapies, particularly from a biological point of view.

Identifiants

pubmed: 36655209
doi: 10.1007/s43465-022-00767-5
pii: 767
pmc: PMC9789216
doi:

Types de publication

Journal Article

Langues

eng

Pagination

137-145

Informations de copyright

© The Author(s) 2022.

Déclaration de conflit d'intérêts

Conflict of InterestsThe authors declare that they have no conflicts of interest concerning this article. No financial support has been received by the authors for the preparation of this paper.

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Auteurs

Diego Gaddi (D)

Department of Orthopedic Surgery, Policlinico San Pietro, Strada Statale 18, 23826 IT Mandello del Lario, LC Italy.

Simone D Gatti (SD)

School of Medicine and Surgery, University of Milano-Bicocca, Via Rismondo 62, Seregno, 20831 IT Monza, MB Italy.

Massimiliano Piatti (M)

Department of Orthopedic Surgery, Policlinico San Pietro, Strada Statale 18, 23826 IT Mandello del Lario, LC Italy.

Andrea Poli (A)

Orthopedic Department, Carate Brianza Hospital, Via Don Luigi Monza 14/B Carate B.Za, 23900 IT Lecco, LC Italy.

Laura De Rosa (L)

Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy.
School of Medicine and Surgery, University of Milano-Bicocca, Via Rismondo 62, Seregno, 20831 IT Monza, MB Italy.

Andrea Riganti (A)

Department of Economics, Management and Quantitative Methods, University of Milano Statale, Via Speri Della Chiesa 28, 21100 IT Milan, VA Italy.

Giovanni Zatti (G)

Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy.
School of Medicine and Surgery, University of Milano-Bicocca, Via Rismondo 62, Seregno, 20831 IT Monza, MB Italy.

Marco Bigoni (M)

School of Medicine and Surgery, University of Milano-Bicocca, Via Rismondo 62, Seregno, 20831 IT Monza, MB Italy.
Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Hospital Couple Enfant, Via Marcona 15, 20100 IT Grenoble, MI France.
Department of Orthopedic Surgery, Policlinico San Pietro, Strada Statale 18, 23826 IT Mandello del Lario, LC Italy.

Marco Turati (M)

Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy.
Department of Paediatric Orthopedic Surgery, Hospital Couple Enfants, Grenoble Alpes University, Via Filzi 34, Giussano, 20833 IT Grenoble, MB France.
School of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy.

Classifications MeSH