Evidence map›Paper›PMID 41869382›Full record

ArticleFrontiers in surgery2026

Association between fibrinogen concentration and nonunion in fracture patients.

Lili Geng, Zejun Wang, Jinlei Dong, Bingru Lu, Jincan Wang, Yuqin Wang, Yiqing Liu

Abstract read
In one paragraph

Article in Frontiers in surgery, 2026. 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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1 · What the graph read from it

What it found

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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.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Lili GengDepartment of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Zejun WangDepartment of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Jinlei DongDepartment of Orthopaedics Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Bingru LuDepartment of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Jincan WangSchool of Public Health, Shandong First Medical University, Jinan, Shandong, China.
Yuqin WangSchool of Public Health, Shandong First Medical University, Jinan, Shandong, China.
Yiqing LiuDepartment of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Nonunion (non-osteogenic healing) remains a major challenge in fracture management, particularly due to its diagnostic complexity and unpredictable occurrence in clavicle and femoral fractures. This study aimed to investigate the potential association between plasma fibrinogen concentration and the incidence of nonunion in fracture patients, with the objective of identifying a potential biomarker for clinical prediction. Based on retrospective data from Shandong Provincial Hospital Affiliated to Shandong First Medical University (January 2010 to May 2019), we analyzed a cohort of 338 fracture cases, among which 23 (6.8%) developed nonunion. Fibrinogen concentration (AUC = 0.635, 95% CI 0.517-0.752) showed moderate discriminative capability for nonunion. Using smoothing curve fitting techniques and multivariable logistic regression models, the study systematically assessed the dose-response relationship between fibrinogen levels and the risk of nonunion risk, adjusting for confounding factors such as age, sex, injury mechanism, and ASA classification. The results indicated that for every 1 g/L increase in fibrinogen concentration, the risk of nonunion increased significantly by 48% [adjusted odds ratio [OR] = 1.48, 95% confidence interval [CI] not explicitly reported but implied statistical significance]. This association remained statistically significant even after controlling for traditional risk factors such as trauma severity and baseline patient status, suggesting that fibrinogen may influence bone healing through independent pathways. Smoothing curve fitting revealed a nonlinear, dose-dependent increase in nonunion risk with higher fibrinogen levels, potentially guiding the establishment of clinical threshold settings. The study found that elevated plasma fibrinogen levels are independently associated with an increased risk of nonunion, and routine monitoring of fibrinogen concentrations may serve as a promising adjunct tool for early identification of at-risk patients. Future research should focus on elucidating the underlying mechanisms-such as inflammation regulation and extracellular matrix deposition-and validating the predictive value of fibrinogen across different types of fractures to support the development of personalized treatment strategies.

Indexed as

fracturenonunionopen reduction and internal fixation (ORIF)plasma fibrinogenretrospective analysis

Identifiers

PMID41869382
PMCPMC13002598

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