ArticleBMC musculoskeletal disorders2022
Efficacy of adjuvant treatment for fracture nonunion/delayed union: a network meta-analysis of randomized controlled trials.
Article in BMC musculoskeletal disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 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.
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Who cites it
16 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
- Predictors of delayed union after surgical treatment in patients with osteoporotic vertebral compression fractures: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2026Pooled it
- A 44-Year-Old Male Manual Laborer With Nonunion of a Femoral Neck Fracture Treated With Ultrasound-Guided Percutaneous Injections of Platelet-Rich Plasma: A Case Report.The American journal of case reports · 2026Article
- Bioaugmented osteosynthesis: precise monitoring and intervention of the bone healing microenvironment.Bone research · 2025Article
- An Autologous Human Adipose Stem Cell-Derived 3D Osteogenic Implant for Bone Grafting: From Development to First-in-Human Experience.Journal of clinical medicine · 2025Article
- Global Research Trends and Hotspots in Fracture Nonunion and Delayed Union: A 2-Decade Bibliometric Analysis.Indian journal of orthopaedics · 2025Article
- Evidence-based guidelines on orthobiologics.EFORT open reviews · 2025Article
- Effect of Hyaluronic Acid on the Acceleration of Bone Fracture Healing: A Systematic Review.Biomedicines · 2025Review
- Injectable photosensitive bone cement enhancing angiogenesis and osteogenic differentiation for the treatment of bone nonunion.APL bioengineering · 2025Article
- Case Report: Therapeutic potential of traditional Korean herbal medicine Jeopgol-tang in bone regeneration: a case series of delayed union over 5 months.Frontiers in endocrinology · 2025Article
- Highly-Cited Papers on Fracture Non-union - A Bibliometric Analysis of the Global Literature (1990-2023).Indian journal of orthopaedics · 2024Review
- Autologous Growth Factor-Rich Concentrate (GFC) Injection in Non-union of Fractures: A Quasi-experimental Study.Indian journal of orthopaedics · 2024Article
- Femoral Neck Fracture Non-Union: Treatment with Bone Marrow Concentrate, Demineralized Bone Matrix, and Morselized Allograft and Angular Stable Fixation. Report of 2 Cases.Journal of orthopaedic case reports · 2024Article
- Anti-Aging Potential of Platelet Rich Plasma (PRP): Evidence from Osteoarthritis (OA) and Applications in Senescence and Inflammaging.Bioengineering (Basel, Switzerland) · 2023Article
- Treatment of Femoral Shaft Pseudarthrosis, Case Series and Medico-Legal Implications.Journal of clinical medicine · 2022Article
- Recent advances on small molecules in osteogenic differentiation of stem cells and the underlying signaling pathways.Stem cell research & therapy · 2022Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFracture nonunion/delayed union seriously affects physical and mental health and quality of life. The aim of this study was to evaluate the relative efficacy of different adjuvant treatments for nonunion/delayed union by network meta-analysis.
methodsA comprehensive search was performed to identify randomized controlled trials (RCTs) evaluating adjuvant treatment in the management of nonunion/delayed union. A network meta-analysis reporting on healing rate, healing time, and adverse effect (AE) outcomes was conducted to assess and compare different interventions.
resultsThirty studies were included in the analysis. For the healing rate outcome, bone marrow aspirate (BMA) + autologous cancellous bone (ACB) was found to be significantly better than ACB alone (odds ratio: 0.12; 95% confidence interval: 0.03, 0.59). In the ranking results, BMA+ platelet-rich plasma (PRP) (96%), BMA + ACB (90%), and BMA alone (82%) showed relative advantages in the healing rate. Low-intensity pulsed ultrasonography (LIUS) intervention significantly shortened the healing time compared with ACB (SMD: -9.26; 95% CI: - 14.64, - 3.87). LIUS (100%), BMA + PRP (74%), and bone morphogenetic proteins (BMPs) (69%) have relative advantages. Compared with the control, electromagnetic field (EMF) (OR: 13.21; 95% CI: 1.58, 110.40) and extracorporeal shock wave (ESWT) (OR: 4.90; 95% CI: 1.38, 17.43) had a higher AE risk.
conclusionsAmong the current intervention strategies, BMA in combination with PRP and ACB can improve the healing rate of nonunion/delayed union. LIUS can significantly shorten the healing time. EMF and ESWT may have a high risk of AE. However, large-scale, well-designed studies are still needed to confirm the results.
trial registrationRetrospectively registered.
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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.