ArticleArchives of orthopaedic and trauma surgery2025
Risk factors for non-union after distal phalangeal fractures of the hand: a nationwide study in the US.
Article in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Pin orthosis extension block pinning versus conservative treatment for doyle type 4B mallet fractures.Archives of orthopaedic and trauma surgery · 2026Trial
- Autologous Bone Peg Grafting for Distal Phalanx Nonunion: A Report of Two Cases.Journal of hand surgery global online · 2027Article
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Authors and funding
7 authors.
Funding
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Abstract
introductionThis study aims to identify risk factors associated with non-union following distal phalangeal fractures of the hand. MATERIALS AND
methodsThis retrospective cohort study utilized the PearlDiver database (2010-2022) to identify adult patients with distal phalangeal fractures and at least one year of follow-up. Patients were categorized into union and nonunion groups using ICD and CPT codes. Risk factors for nonunion were assessed by analyzing demographics, comorbidities, fracture characteristics (open vs. closed, displaced vs. nondisplaced, number of fractured fingers), and treatment type (surgical: open/percutaneous vs. non-surgical: closed) using chi-square tests, t-tests, and multivariable logistic regression (P < 0.05 was considered significant).
resultsNonunion was reported among 3,378 (3.0%) of the 114,667 patients with distal phalanx fractures. Nonunion patients were older and had greater rates of tobacco use, alcohol abuse, obesity, soft tissue injury, and surgical site infection. Fracture of the thumb was less likely to be associated with nonunion compared with other fingers. Open fracture, compared to closed fracture, and surgical treatment, compared to non-surgical treatment, were among the independent predictors of nonunion.
conclusionsThis study identifies key risk factors for nonunion in distal phalangeal fractures of the hand, including older age, obesity, tobacco use, alcohol abuse, displaced fractures, and surgical treatment. Addressing modifiable risk factors, such as smoking cessation and weight management, may help reduce the risk of nonunion. Further prospective studies are warranted to better understand additional contributors to bone healing.
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