ReviewEFORT open reviews2022
Risk factors for nonunion following surgically managed, traumatic, diaphyseal fractures: a systematic review and meta-analysis.
Review in EFORT open reviews, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis 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
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Performance of prediction models for delayed union and nonunion after fracture: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2026Pooled it
- Antibiotic Selection for Sustained Local Therapy May Be Important to ReduceMicroorganisms · 2026Article
- Body mass index, weight bearing, and delayed union after femoral shaft fracture nailing: a retrospective cohort study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Review
- 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
- The economic burden in terms of cost of illness and generic health-related quality of life of posttraumatic long bone non-unions among the adult population of the Netherlands from a societal perspective.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Nonunion After Ankle Arthrodesis: A Contemporary Review.Foot & ankle international · 2026Review
- Long-term outcomes of vascularized fibular grafting for infected non-union of the lower limb: a competing-risk analysis.Journal of bone and joint infection · 2026Article
- Surgical treatment of non-unions in the ulna and radius: a one-year outcome study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Modern Approaches and Emerging Biological Therapies to Treat Fracture Nonunion.Pharmaceutics · 2025Review
- Clinical and Sociodemographic Characterization of Mexican Cohort with Pseudoarthrosis: A Retrospective, Cross-Sectional, and Descriptive Study.Reports (MDPI) · 2025Article
- Correlation between Vitamin D Levels and Healing Time in Lower Limb Fractures.Journal of orthopaedic case reports · 2025Article
- Global Research Trends and Hotspots in Fracture Nonunion and Delayed Union: A 2-Decade Bibliometric Analysis.Indian journal of orthopaedics · 2025Article
- Efficacy of biomarkers in the endochondral phase of fracture repair and healing in long bones: A clinical observational studys.PLoS medicine · 2025Observational
- The sole use of stem cells in treating fracture nonunion: a scoping review.Archives of orthopaedic and trauma surgery · 2025Article
- Exploring the relationship between frailty and nonunion fractures in upper extremity injuries: insights from the national inpatient sample.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- The Genetic and Biological Basis of Pseudoarthrosis in Fractures: Current Understanding and Future Directions.Diseases (Basel, Switzerland) · 2025Review
- Surgical and microbiological characteristics that influence the probability of reoperation to promote bone healing after fracture-related infection diagnosis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Managing Nonunion in Orthopedic Surgery.Indian journal of orthopaedics · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: There are several studies on nonunion, but there are no systematic overviews of the current evidence of risk factors for nonunion. The aim of this study was to systematically review risk factors for nonunion following surgically managed, traumatic, diaphyseal fractures. Methods: Medline, Embase, Scopus, and Cochrane were searched using a search string developed with aid from a scientific librarian. The studies were screened independently by two authors using Covidence. We solely included studies with at least ten nonunions. Eligible study data were extracted, and the studies were critically appraised. We performed random-effects meta-analyses for those risk factors included in five or more studies. PROSPERO registration number: CRD42021235213. Results: Of 11,738 records screened, 30 were eligible, and these included 38,465 patients. Twenty-five studies were eligible for meta-analyses. Nonunion was associated with smoking (odds ratio (OR): 1.7, 95% CI: 1.2-2.4), open fractures (OR: 2.6, 95% CI: 1.8-3.9), diabetes (OR: 1.6, 95% CI: 1.3-2.0), infection (OR: 7.0, 95% CI: 3.2-15.0), obesity (OR: 1.5, 95% CI: 1.1-1.9), increasing Gustilo classification (OR: 2.2, 95% CI: 1.4-3.7), and AO classification (OR: 2.4, 95% CI: 1.5-3.7). The studies were generally assessed to be of poor quality, mainly because of the possible risk of bias due to confounding, unclear outcome measurements, and missing data. Conclusion: Establishing compelling evidence is challenging because the current studies are observational and at risk of bias. We conclude that several risk factors are associated with nonunion following surgically managed, traumatic, diaphyseal fractures and should be included as confounders in future studies.
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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.