ArticleJournal of orthopaedics2025
Application of the LEG NUI score to assess revision success in established distal femur non-unions.
Article in Journal of orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Performance of prediction models for delayed union and nonunion after fracture: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2026Pooled it
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Authors and funding
8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: The incidence of non-union following distal femur fractures is high. Management of persis-tent non-unions is challenging, often requiring multiple revision surgeries, thereby increasing patient morbidity and socioeconomic burden. Identifying patients at high risk for persistent non-union after revision is therefore crucial. The LEG NUI Score was originally developed to predict the need for early intervention following primary fixation of distal femur fractures. This study aimed to evaluate the LEG NUI Score's ability to predict the need for further revision surgery in a cohort of patients with established distal femur non-union undergoing their index revision procedure. Patients and methods: 45 patients with complete clinical data were identified from a non-union database. The LEG NUI Score was calculated for the index revision procedure and assessed in relation to the healing out-come of the revision treatment. Comparative statistics and test characteristics were assessed, as well as a receiver operator characteristic analysis was performed. Only patients with uneventful healing after the first treatment were considered healed for the score calculation. Patients requiring more than one surgery, including second step masquelet were considered non-healers. Results: The union rate (healed non-unions) after the first non-union revision surgery was 55.5 %. 24.4 % of patients had an infected non-union. The average LEG NUI Score in patients with non-union healing was significantly lower than non-healing patients (3.36 ± 1.80 vs. 4.90 ± 1.21; p < 0.05). The AUC in the ROC Analysis was 0.755. Discussion: The LEG NUI Score shows potential applicability in the setting of revision surgery for established distal femur non-unions. Calculating the score may help surgeons identifying patients at in-creased risk for requiring subsequent surgical procedures, thus warranting closer postoperative surveillance. Further validation in larger cohorts is required to fully elucidate its clinical utility in this context. Level of evidence: Level III, Retrospective Cohort Study.
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