ArticleThe Journal of bone and joint surgery. American volume2015
Time Trade-Off as a Measure of Health-Related Quality of Life: Long Bone Nonunions Have a Devastating Impact.
Article in The Journal of bone and joint surgery. American volume, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03126448 (Prospective Evaluation of Bacterial Burden in Orthopaedic Trauma Procedures Using Highly Sensitive Assays), which is not on this map. Cited by 42 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prospective Evaluation of Bacterial Burden in Orthopaedic Trauma Procedures Using Highly Sensitive Assays
Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Efficacy and safety of biological agents and physical therapies for delayed union or nonunion of fractures: a network meta-analysis of randomized controlled trials.BMC musculoskeletal disorders · 2026Pooled it
- Pooled it
- Maladaptive immune-fibrotic axis drives impaired long bone regeneration under mechanical instability.Science advances · 2026Article
- Recurrent Midshaft Clavicle Nonunion with a Large Segmental Bone Defect Treated with Autologous Iliac Crest Bone Graft and Dual Plating: A Case Report.Journal of orthopaedic case reports · 2026Article
- Incidence of nonunion after open tibia fractures in Malawi : associated factors and Radiographic Union Score for Tibial fractures reliability.Bone & joint open · 2026Article
- Internal fixation through posterolateral approach versus Ilizarov external fixation for treatment of aseptic distal tibia nonunion: a comparative analysis.Musculoskeletal surgery · 2026Article
- Modern Approaches and Emerging Biological Therapies to Treat Fracture Nonunion.Pharmaceutics · 2025Review
- Long-Term Evaluation of Bone Healing Monitoring Using an Instrumented Plate with Measurement Sensors (Smart Implant) over 10 Years.Sensors (Basel, Switzerland) · 2025Article
- Time to consider fracture nonunion an orphan disease? An update into pathophysiology, epidemiology and therapeutic solutions.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Review
- Cracking the code: Understanding ESWT's role in bone fracture healing.Journal of orthopaedic translation · 2025Review
- Use of medialized trochanteric-entry intramedullary nail to improve alignment in proximal femur nonunions.International orthopaedics · 2025Article
- Activation of Wnt signaling in human fracture callus and nonunion tissues.Bone reports · 2024Article
- Clinical, Radiologic, and Functional Outcomes following Bone Grafting for Metacarpal Non-Unions: A Systematic Review.Journal of clinical medicine · 2024Review
- Autologous non-vascularized fibula with compression plating in the management of aseptic complex non-union of long bones.International journal of burns and trauma · 2024Article
- Ulnar Resection Length: A Risk Factor for Nonunion in Ulnar Shortening Osteotomy.Hand (New York, N.Y.) · 2024Article
- Prognostic implications of a CD8Frontiers in immunology · 2024Article
- Induced membrane technique versus one-stage autografting in management of atrophic nonunion of long bone in the lower limb: clinical and health burden outcomes.Journal of orthopaedic surgery and research · 2023Article
- Large segmental defects in midshaft clavicle nonunion treated with autologous tricortical iliac crest bone graft.Shoulder & elbow · 2023Article
- Use of Conditionally Essential Amino Acids and the Economic Burden of Postoperative Complications After Fracture Fixation: Results from a Cost Utility Analysis.ClinicoEconomics and outcomes research : CEOR · 2023Article
- Parathyroid hormone therapy improves MRSA-infected fracture healing in a murine diabetic model.Frontiers in cellular and infection microbiology · 2023Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLong bone nonunions have an important impact on a patient's quality of life. The purpose of this study was to compare long bone nonunions with use of the Time Trade-Off direct measure to compute utility scores and to determine which nonunion anatomic location had the lowest health-related quality of life. The Time Trade-Off assesses the percentage of a patient's remaining life that the patient would be willing to trade for perfect health.
methodsEight hundred and thirty-two consecutive long bone nonunions with Time Trade-Off data were identified and were retrospectively studied from a prospectively collected patient database. Nonunions with infections and those involving the articular portion of the bone were recorded. Time Trade-Off utility scores were obtained for all nonunion cases upon their initial clinical evaluation by a single surgeon specializing in reconstructive trauma.
resultsThe mean utility score of our nonunion cohort was 0.68 and it differed significantly by long bone (p = 0.037). Nonunions of the forearm had the lowest utility score (0.54), followed by the clavicle (0.59), femur (0.68), tibia or fibula (0.68), and humerus (0.71). Post hoc tests showed that patients with nonunions of the forearm had significantly lower utility scores (p = 0.031) compared with all other bones.
conclusionsPatients diagnosed with a long bone nonunion have a very low health-related quality of life. We found that this single cohort's mean utility score was 0.68. This result is well below that of illnesses such as type-I diabetes mellitus (0.88), stroke (0.81), and acquired immunodeficiency syndrome (0.79). We found that patients with forearm nonunions had the lowest utility scores. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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