Evidence map›Paper›PMID 40056248›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025

Identification of clinical risk factors and optimal inflammatory marker cutoffs for the diagnosis of septic nonunion at time of presentation.

Tyler J Moon, Lucas R Haase, Andrew Burcke, George Ochenjele, Robert J Wetzel, John K Sontich, Joshua K Napora

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Tyler J MoonDepartment of Orthopedic Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA. tyler.moon@uhhospitals.org.ORCID http://orcid.org/0000-0003-0132-9548
Lucas R HaaseDepartment of Orthopedic Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Andrew BurckeCase Western Reserve University School of Medicine, Cleveland, Ohio, USA.
George OchenjeleDepartment of Orthopedic Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Robert J WetzelDepartment of Orthopedic Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
John K SontichDepartment of Orthopedic Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Joshua K NaporaDepartment of Orthopedic Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe diagnosis of septic nonunion is difficult due to the risk of occult presentation. The purpose of this study is to identify risk factors for infection prior to nonunion surgery.

methodsThis retrospective cohort study was completed at a single tertiary referral level one trauma center. Patients were included if they had surgery to repair a nonunion of the femur, tibia, or humerus after operative initial management. Predictors for septic nonunion were determined based on clinical, laboratory, and radiographic findings.

results122 Patients met inclusion criteria. 28 Patients (23.0%) were diagnosed with septic nonunion. Clinical risk factors for septic nonunion diagnosis on multivariate regression included nonunion surgery performed at an outside hospital prior to referral (p = 0.003) and early infection requiring debridement within 60 days of initial injury (p = 0.01). Ideal inflammatory marker cutoffs based on ROC curves included WBC > 8.1 × 10

conclusionThis study demonstrates additional clinical risk factors and re-defines cutoff values for laboratory biomarkers as predictors for diagnosis of septic nonunion. These data may help providers better identify cases of septic nonunion prior to nonunion surgery.

Indexed as

Fractures, UnunitedSepsisSurgical Wound InfectionAdultAgedBiomarkersC-Reactive ProteinDebridementFemaleFemoral FracturesHumansHumeral FracturesLeukocyte CountMaleMiddle AgedRetrospective StudiesBiomarkersC-Reactive ProteinFracture-related infectionInfectious biomarkersNonunionNonunion revision surgerySeptic nonunion

Identifiers

PMID40056248

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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.