ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2026
Association between perioperative allogenic blood transfusion and risk of fracture related infection and nonunion in operatively treated tibial shaft fractures.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRecent orthopaedic trauma literature has linked blood transfusions with poor outcomes due to proposed deleterious effects on healing. The aim of this study was to determine the association of perioperative allogenic blood transfusion after tibial shaft fixation with nonunion and fracture related infection (FRI).
methodsA retrospective cohort of patients at two level 1 trauma centers over a 12-year period who sustained extra-articular tibial shaft fractures treated with intermedullary nailing (IMN) or open reduction internal fixation (ORIF). A minimum follow-up of six months was required unless there was presence of clinical and radiographic union prior to six months. Peri-operative allogenic red blood cell transfusion was the primary independent variable. Outcomes included fracture-related infection (FRI) and nonunion. Sub-analyses were completed in patients with open and closed fractures separately.
results550 tibia fractures met inclusion criteria. Mean age was 45 years. 333 (61%) patients were male. 247 (45%) patients were current tobacco users. 335 (59%) patients sustained a high energy fracture mechanism. 71 fractures (13%) were classified as AO/OTA 42-C and 230 fractures (42%) were open. Mean follow up was 18.2 ± 17 months. 138 patients (25%) received a peri-operative blood transfusion. 54 patients (10%) were diagnosed with FRI and 86 patients (16%) were diagnosed with nonunion. Multivariate regression analysis demonstrated no independent association between transfusion and FRI for the whole cohort (OR 1.6; 95% CI 0.9–2.9; p = 0.1) or in patients with open fracture (N = 230, 19% transfusion versus 14% no transfusion, p = 0.3). Multivariate regression analysis demonstrated no independent association between transfusion and nonunion for the whole cohort (OR 1.8; 95% CI 0.9–3.3; p = 0.1) but did demonstrate an independent association for patients with open fractures (N = 230, OR 2.0; 95% CI 1.1–3.7; p = 0.03).
conclusionsThis multicenter study demonstrated that nonunion, but not FRI, may be associated with peri-operative red blood cell transfusion in open tibial shaft fractures. Surgeons may consider indications for transfusion after open tibia fracture fixation to minimize risk of poor outcomes. LEVEL OF EVIDENCE: Level III Prognostic.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.