SynthesisJournal of orthopaedic surgery and research2020
Prevalence and influencing factors of nonunion in patients with tibial fracture: systematic review and meta-analysis.
Synthesis in Journal of orthopaedic surgery and research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 113 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
113 citing papers in PubMed, 4 syntheses or guidelines pooled it, 171 citations in OpenAlex.
- Diabetes and the risk of delayed union or non-union of fractures: evidence from a systematic review and meta-analysis.Scientific reports · 2026Pooled it
- Do NSAIDs affect bone healing rate, delay union, or cause non-union: an updated systematic review and meta-analysis.Frontiers in endocrinology · 2024Pooled it
- In reply to the letter to the editor regarding "Comparison of a twin interlocking derotation and compression screw cephalomedullary nail (InterTAN) with a single screw derotation cephalomedullary nail (proximal femoral nail antirotation): a systematic review and meta-analysis for intertrochanteric fractures".Journal of orthopaedic surgery and research · 2022Pooled it
- Delayed Tibial Shaft Fracture Healing Associated with Smoking: A Systematic Review and Meta-Analysis of Observational Studies Conducted Worldwide.International journal of environmental research and public health · 2021Pooled it
- Primary dynamization versus standard static interlocking nailing in treatment of tibial shaft fractures in adults: a randomized controlled trial.BMC musculoskeletal disorders · 2025Trial
- Value of negative pressure sealing drainage on wound healing of Gustilo IIIB and IIIC open fractures.World journal of clinical cases · 2024Trial
- Article
- Predicting nonunion - a hybrid machine-learning model combining patient factors and mechanobiological simulation features exceeds clinician accuracy.Bone & joint research · 2026Article
- Identification of biomechanical alterations associated with nonunion after tibial shaft fractures using musculoskeletal simulation based on motion capture and instrumented insole data.Archives of orthopaedic and trauma surgery · 2026Article
- Long-term radiological and clinical outcomes after surgical treatment of non-union: a ten-year follow-up study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Clinical Characteristics of Patients with Long-Bone Fracture Nonunion and Delayed Union and Factors Associated with Infection: A Retrospective Single-Center Cohort Study.Journal of clinical medicine · 2026Article
- Association between visceral adiposity index and delayed union/nonunion after tibial or femoral shaft fractures: a single-center retrospective cohort study.BMC musculoskeletal disorders · 2026Article
- Femoral diaphysis malunion: An overview.Journal of clinical orthopaedics and trauma · 2026Review
- Rates of union and risk factors for continued nonunion following exchange nailing of tibial nonunion.Archives of orthopaedic and trauma surgery · 2026Article
- Association between perioperative allogenic blood transfusion and risk of fracture related infection and nonunion in operatively treated tibial shaft fractures.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Open Reduction and Treatment with Bone Morphogenetic Protein-2 for Correction of Closed Tibial Pseudoarthrosis in a 32-Year-Old Non-smoking Male with Osteoporosis and Hypogonadism: A Case Report.Journal of orthopaedic case reports · 2026Article
- Surgically Treated Non-Unions and Fractures of the Femur and Tibia in Adults: A Nationwide Analysis of 888,442 Cases from the German InEK Database.Journal of epidemiology and global health · 2026Article
- Biomechanical evaluation of X-ray permeable CF/PEEK composite versus conventional titanium alloy for tibial external fixation plates: a finite element analysis.Scientific reports · 2026Article
- Article
- Microbiology, risk factors, and clinical outcomes of low-grade infection in long-bone diaphyseal non-union after open fracture.International orthopaedics · 2026Article
53 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe aim of this study is to assess the prevalence of nonunion in patients with tibia fracture and the association between influencing factors and tibia fracture nonunion.
methodA database searches of PubMed, the Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Weipu database, and Wanfang database from inception until June 2019 was conducted. The pooled prevalence, odds ratio (OR), and 95% confidence intervals (CI) were calculated with Stata software.
resultsIn this study, 111 studies involving 41,429 subjects were included. In the study of the relationship between influencing factors and tibia fracture nonunion, 15 factors significantly influenced the fracture union, including > 60 years old, male, tobacco smoker, body mass index > 40, diabetes, nonsteroidal anti-inflammatory drugs (NSAIDs) user, opioids user, fracture of middle and distal tibia, high-energy fracture, open fracture, Gustilo-Anderson grade IIIB or IIIC, Müller AO Classification of Fractures C, open reduction, fixation model, and infection.
conclusionThe prevalence of nonunion in patients with tibia fracture was 0.068 and 15 potential factors were associated with the prevalence. Closed reduction and minimally invasive percutaneous plate osteosynthesis (MIPPO) have the low risks of nonunion for the treatment of tibial fractures.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.