ArticleBone & joint research2022
The epidemiology and direct healthcare costs of aseptic nonunions in Germany - a descriptive report.
Article in Bone & joint research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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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.
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Who cites it
16 citing papers in PubMed, 20 citations in OpenAlex.
- 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
- [Adjunctive therapies in geriatric ankle fracture patients].Unfallchirurgie (Heidelberg, Germany) · 2026Review
- Granulate-to-Filament: An Extrusion-Mixed PLA-Human Bone Material System for 3D-Printed Bone Scaffolds.Journal of functional biomaterials · 2026Article
- Epidemiology of non-unions following foot and ankle fractures: a nationwide analysis from 2014 to 2023.BMC musculoskeletal disorders · 2026Article
- Challenges and solutions in determining urolithiasis caseloads using the digital infrastructure of a clinical data warehouse.PloS one · 2026Article
- Managing Nonunions and Fracture-Related Infections-A Quarter Century of Knowledge, and Still Curious: A Narrative Review.Journal of clinical medicine · 2025Review
- 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
- Global Research Trends and Hotspots in Fracture Nonunion and Delayed Union: A 2-Decade Bibliometric Analysis.Indian journal of orthopaedics · 2025Article
- 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
- The Power of Heuristics in Predicting Fracture Nonunion.Journal of clinical medicine · 2025Article
- A study on early diagnosis for fracture non-union prediction using deep learning and bone morphometric parameters.Frontiers in medicine · 2025Article
- Treatment of High-Grade Chronic Osteomyelitis and Nonunions with PerOssalJournal of clinical medicine · 2024Article
- Non-Union Treatment in the Foot, Ankle, and Lower Leg: A Multicenter Retrospective Study Comparing Conventional Treatment with the Human Allogeneic Cortical Bone Screw (Shark ScrewJournal of personalized medicine · 2024Article
- Treatment rates and healthcare costs of patients with fragility fracture by site of care: a real-world data analysis.Archives of osteoporosis · 2023Article
- Bone Healing Gone Wrong: Pathological Fracture Healing and Non-Unions-Overview of Basic and Clinical Aspects and Systematic Review of Risk Factors.Bioengineering (Basel, Switzerland) · 2023Review
- Direct Healthcare Cost of Fracture-related Infection Treatment.JB & JS open accessArticle
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThis observational cross-sectional study aimed to answer the following questions: 1) how has nonunion incidence developed from 2009 to 2019 in a nationwide cohort; 2) what is the age and sex distribution of nonunions for distinct anatomical nonunion localizations; and 3) how high were the costs for surgical nonunion treatment in a level 1 trauma centre in Germany?
methodsData consisting of annual International Classification of Diseases (ICD)-10 diagnosis codes from German medical institutions from 2009 to 2019, provided by the Federal Statistical Office of Germany (Destatis), were analyzed. Nonunion incidence was calculated for anatomical localization, sex, and age groups. Incidence rate ratios (IRRs) were determined and compared with a two-sample z-test. Diagnosis-related group (DRG)-reimbursement and length of hospital stay were retrospectively retrieved for each anatomical localization, considering 210 patients.
resultsIn 2019, a total of 11,840 nonunion cases (17.4/100,000 inhabitants) were treated. In comparison to 2018, the incidence of nonunion increased by 3% (IRR 1.03, 95% confidence interval (CI) 0.53 to 1.99, p = 0.935). The incidence was higher for male cases (IRR female/male: 0.79, 95% CI 0.76 to 0.82, p = 0.484). Most nonunions occurred at the pelvic and hip region (3.6/100,000 inhabitants, 95% CI 3.5 to 3.8), followed by the ankle and foot as well as the hand (2.9/100,000 inhabitants each). Mean estimated DRG reimbursement for in-hospital treatment of nonunions was highest for nonunions at the pelvic and hip region (€8,319 (SD 2,410), p < 0.001).
conclusionDespite attempts to improve fracture treatment in recent years, nonunions remain a problem for orthopaedic and trauma surgery, with a stable incidence throughout the last decade.Cite this article:
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