Evidence map›Paper›PMID 41113894›Full record

ReviewCureus2025

Outcomes Following Vascularised Bone Graft for the Treatment of Upper Limb Osteomyelitis: A Systematic Review and Meta-Analysis.

Alex L Starkey, Mantaran S Bakshi, Harsimran Kaur Surinder Singh, Sanjana A Shetty, Osamah Al-Zubaidi, Leto A Warie, Ahmed El Shinnawi, Batool E Kareem, Samuel Teklay, Abdal Q Zafar

Abstract readReview
In one paragraph

Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Alex L StarkeyTrauma and Orthopaedics, Royal Lancaster Infirmary, Lancaster, GBR.
Mantaran S BakshiSpinal Surgery, Southmead and Bristol Children's Hospital, Bristol, GBR.
Harsimran Kaur Surinder SinghGeneral Surgery, St. Helier Hospital, London, GBR.
Sanjana A ShettyEar, Nose, and Throat, Queen Alexandra Hospital, Portsmouth, GBR.
Osamah Al-ZubaidiPlastic Surgery, Castle Hill Hospital, Hull, GBR.
Leto A WarieOral Maxillofacial Surgery, Hull Royal Infirmary, Hull, GBR.
Ahmed El ShinnawiEmergency Medicine, Queen's Hospital, Romford, GBR.
Batool E KareemEmergency Medicine, Tunbridge Wells Hospital, Kent, GBR.
Samuel TeklayPlastic Surgery, Pinderfields Hospital, Wakefield, GBR.
Abdal Q ZafarTrauma and Orthopaedics, Whittington Hospital, London, GBR.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Osteomyelitis is a debilitating condition with treatment options ranging from antibiotics to surgical management. In cases where debridement of necrotic or infected tissue results in extensive bone and soft-tissue loss, creating a poorly vascularised cavity prone to persistent infection and mechanical instability, vascularised bone grafts (VBGs) can provide definitive reconstruction. This systematic review and meta-analysis aimed to assess outcomes of VBGs for upper limb osteomyelitis. A systematic search of electronic databases identified 330 papers related to VBGs, of which 10 retrospective case series met the inclusion criteria, cumulatively including 70 patients. Statistical analysis was performed using Open MetaAnalyst software (Center for Evidence-Based Medicine, Brown University, Providence, RI, US) with a random-effects model and 95% confidence intervals. The mean time to bony union post-VBG was 6.2 months, with 59 (87.7%) patients achieving union. Secondary surgery was required for 19 (26.1%) patients, and postoperative infection recurrence occurred in three (5.1%). Postoperative stress fracture was reported in one case with an overall incidence of 5.5%. These findings indicate that VBGs are an effective treatment for upper limb osteomyelitis, yielding high rates of bony union and a low incidence of complications. Compared with other treatment modalities, patients undergoing VBGs may benefit from shorter antibiotic courses and improved outcomes. Whilst the included studies were limited to retrospective series, this pooled analysis provides evidence supporting the use of VBGs as a reliable surgical option for complex upper limb osteomyelitis.

Indexed as

autologous bone graftfree vascularised fibular graftosteomyelitis treatmentplastic and reconstructive surgeryupper limb reconstructionupper limb surgeryvascularised bone graftingvascularized bone graft

Identifiers

PMID41113894
PMCPMC12533982

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Registered trials

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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.