ArticleEFORT open reviews2020
Nonunion - consensus from the 4th annual meeting of the Danish Orthopaedic Trauma Society.
Article in EFORT open reviews, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 2 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Performance of prediction models for delayed union and nonunion after fracture: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2026Pooled it
- Clinical Application of Adipose Derived Stem Cells for the Treatment of Aseptic Non-Unions: Current Stage and Future Perspectives-Systematic Review.International journal of molecular sciences · 2022Pooled it
- Discrepancy Between Biological Activity and Functional Fracture Healing Following Vitamin K2 Supplementation in an Ovariectomized Rat Model of Osteoporosis.Journal of clinical medicine · 2026Article
- Bone Formation Between 2.5 and 25% Interfragmentary Strain Induced by Immediate and Delayed Loading in a Bone Healing Model with a Monotonic Strain Gradient.Annals of biomedical engineering · 2026Article
- Management of Fracture Non-union in Children: A Literature Review With Two Case Studies.Cureus · 2025Article
- Total flavonoids of rhizoma drynariae improved the osteogenic and pro-angiogenic capacities of BMSCs to accelerate long bone regeneration.Scientific reports · 2025Article
- Non-Union Treatment in the Shoulder, Arm, Wrist, and Fingers: A Multicentre Retrospective Study Comparing Conventional Treatment with the Human Allogeneic Cortical Bone Screw (Shark ScrewLife (Basel, Switzerland) · 2025Article
- Efficacy of biomarkers in the endochondral phase of fracture repair and healing in long bones: A clinical observational studys.PLoS medicine · 2025Observational
- 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
- Membrane Filtration of Sonication Fluid-A Promising Adjunctive Method for the Diagnosis of Low-Grade Infection in Presumed Aseptic Nonunion.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025Article
- Pedicled medial femoral condyle corticoperiosteal flap for achieving union in patients with nonunion of the distal half of the femur (A short case series of three patients).BMC musculoskeletal disorders · 2025Article
- The Genetic and Biological Basis of Pseudoarthrosis in Fractures: Current Understanding and Future Directions.Diseases (Basel, Switzerland) · 2025Review
- Teriparatide as a non-surgical salvage therapy for prolonged humerus fracture nonunion: A case report and literature review.World journal of orthopedics · 2025Article
- Load-bearing aerobic exercise prior to injury moderates systemic immunosuppression response to fracture.Frontiers in physiology · 2025Article
- Following Multiple Failed Reconstructions of a Distal Femur Fracture, Osseous Union Achieved After Superficial Femoral Artery Endarterectomy.Ochsner journal · 2025Article
- State of the Nonunion: A review of the latest literature.Orthopedic reviews · 2025Article
- Management of Distal Femoral Non-union: A Systematic Review.Indian journal of orthopaedics · 2024Review
- The Use of Nitinol Continuous Compression Implants in Orthopaedic Trauma.Indian journal of orthopaedics · 2024Article
- Hypertrophic nonunion management with distraction osteogenesis: a scoping review of the literature.OTA international : the open access journal of orthopaedic trauma · 2024Article
- Effects of Autologous Conditioned Serum on Non-Union After Open Reduction Internal Fixation Failure: A Case Series and Literature Review.Medicina (Kaunas, Lithuania) · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Nonunions are a relevant economic burden affecting about 1.9% of all fractures. Rather than specifying a certain time frame, a nonunion is better defined as a fracture that will not heal without further intervention.Successful fracture healing depends on local biology, biomechanics and a variety of systemic factors. All components can principally be decisive and determine the classification of atrophic, oligotrophic or hypertrophic nonunions. Treatment prioritizes mechanics before biology.The degree of motion between fracture parts is the key for healing and is described by strain theory. If the change of length at a given load is > 10%, fibrous tissue and not bone is formed. Therefore, simple fractures require absolute and complex fractures relative stability.The main characteristics of a nonunion are pain while weight bearing, and persistent fracture lines on X-ray.Treatment concepts such as 'mechanobiology' or the 'diamond concept' determine the applied osteosynthesis considering soft tissue, local biology and stability. Fine wire circular external fixation is considered the only form of true biologic fixation due to its ability to eliminate parasitic motions while maintaining load-dependent axial stiffness. Nailing provides intramedullary stability and biology via reaming. Plates are successful when complex fractures turn into simple nonunions demanding absolute stability. Despite available alternatives, autograft is the gold standard for providing osteoinductive and osteoconductive stimuli.The infected nonunion remains a challenge. Bacteria, especially staphylococcus species, have developed mechanisms to survive such as biofilm formation, inactive forms and internalization. Therefore, radical debridement and specific antibiotics are necessary prior to reconstruction. Cite this article:
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