ArticleInternational orthopaedics2020
Leeds-Genoa Non-Union Index: a clinical tool for asessing the need for early intervention after long bone fracture fixation.
Article in International orthopaedics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Performance of prediction models for delayed union and nonunion after fracture: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2026Pooled it
- Predicting nonunion - a hybrid machine-learning model combining patient factors and mechanobiological simulation features exceeds clinician accuracy.Bone & joint research · 2026Article
- Anticipating femoral shaft nonunion at 1-3 months: a multimodal framework with automated X‑ray segmentation despite metal implants.International orthopaedics · 2026Article
- Development and validation of a nomogram model for predicting postoperative nonunion in femoral shaft fractures.BMC musculoskeletal disorders · 2025Article
- Application of the LEG NUI score to assess revision success in established distal femur non-unions.Journal of orthopaedics · 2025Article
- Article
- Tibial Malalignment Is an Independent Predictor of Nonunion After Intramedullary Nailing of Tibial Shaft Fractures.Journal of orthopaedic trauma · 2025Article
- Dual-channel minimally invasive percutaneous cerclage for femoral shaft and metaphysis fractures during the internal fixation with intramedullary nails: case reports and technical description.Quantitative imaging in medicine and surgery · 2024Article
- A Scoring System for Predicting Nonunion After Intramedullary Nailing of Femoral Shaft Fractures.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2024Article
- Analysis of the influence of circumference and displacement of the third fracture fragment on the healing of femoral shaft fractures treated with intramedullary nailing.Scientific reports · 2024Article
- Three predictive scores compared in a retrospective multicenter study of nonunion tibial shaft fracture.World journal of orthopedics · 2024Article
- [Artificial intelligence and novel approaches for treatment of non-union in bone : From established standard methods in medicine up to novel fields of research].Unfallchirurgie (Heidelberg, Germany) · 2022Review
- Risk factors for nonunion following surgically managed, traumatic, diaphyseal fractures: a systematic review and meta-analysis.EFORT open reviews · 2022Review
- Bridge plating with decortication, autologous bone graft, and tight closure: a "stepwise surgical diamond concept" for treatment of nonunion in a series of fifty five patients.International orthopaedics · 2022Article
- Scoring systems for early prediction of tibial fracture non-union: an update.International orthopaedics · 2021Article
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3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
aim of the studyThe aim of this case-control study was to develop a clinical decision rule to support assessment of the risk of long-bone non-union and plan for appropriate early intervention.
methodsTwo hundred patients (100 cases and 100 controls) were recruited. Risk factors identified to contribute to the development of non-union were recorded and analysed with a multivariable logistic regression model. Tabulation of the outcome (non-union/union) against each risk factor in turn (univariable analysis) was carried out. Odds ratios and confidence intervals were derived using Wald's method. A receiver-operator curve was calculated and the area under the curve was computed. Having established the eight most important risk factors, a non-union risk index was developed as the count of the risk factors present in each patient.
resultsThe five risk factors for non-union with greater effect size were post-surgical fracture gap > 4 mm (odds ratio (OR) = 11.97 95% CI (4.27, 33.53)), infection superficial/deep (OR 10.16 (2.44, 42.36)), not optimum mechanical stability (OR 10.06 (3.75, 26.97)), displacement > 75% of shaft width (OR 6.81 (2.21, 20.95)), and site of fracture-tibia (OR 4.33 (1.32, 14.14)). The ROC curve for the non-union index was 0.924, sensitivity 91%, specificity 77%.
conclusionsThe non-union index derived from counting risk factors predicts union for 0-4 risk factors and non-union for 5-8 risk factors. It can be readily applied and can guide clinicians about the risk of development of long-bone non-union. It can become a powerful aid for assessing fracture fixation outcome and to support early intervention.
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