Long-term functional outcome and quality of life after successful surgical treatment of tibial nonunions

Wichlas, Florian; Tsitsilonis, Serafeim; Disch, Alexander C.; Haas, Norbert; Hartmann, Christian; Graef, Frank; Schwabe, Philipp

doi:10.1007/s00264-014-2629-y

Cited by 16 publications

(24 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Following our exclusion criteria, we excluded 1268 and the resulting 107 papers were further screened against our inclusion criteria. Eventually, 13 papers were included in our review [7,8,9,10,15,16,17,18,19,20,21,22,23]. All 13 studies were considered for qualitative analysis and seven of them for quantitative analysis [8,9,17,19,20,22,23] (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…Nearly half of the included studies (six) came from United States of America [8,11,13,16,17,18], four from Germany [8,10,19,23] and the rest each one from Canada [15], Greece [20], and Australia [7]. Five of them have been published by the same team: three by Brinker et al (USA) in different years (2007, 2013 and 2017) [8,17,22] and two by Moghaddam et al (Germany), in 2015 and 2017 [19,23].…”

Section: Resultsmentioning

confidence: 99%

“…The list of included studies along with their demographic and baseline characteristics are illustrated in Table 1. In most studies (nine) [7,8,9,10,15,19,20,21,22], males outnumbered females and in half of them (four) [7,10,15,19] the number of females was less than one-third of the number of males. Two studies included more females than males [17,18], one study had an equal sex distribution [23] and in one, this is unknown [16].…”

Section: Resultsmentioning

confidence: 99%

“…Despite the limited investigation into the physical health/psychosocial functioning of patients suffering from fracture non-unions, the available research has suggested that pseudarthroses are detrimental to patients’ overall physical health and quality of life. Some studies have demonstrated this impact at the point of treatment [7,8], and others have investigated and demonstrated this following patients’ recovery from their non-union [9,10]. Despite these findings, a systematic review of the impact of non-unions on adults’ physical health state, and the relevant psychological impact, has not yet been carried out.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Physical Health and Psychological Outcomes in Adult Patients with Long-Bone Fracture Non-Unions: Evidence Today

Johnson

Igoe

Kleftouris

et al. 2019

JCM

View full text Add to dashboard Cite

Background: Research has suggested that bone fractures can hinder the health status of patients’ life. However, limited research has examined the impact that the healing process of a fracture has on the physical health and psychological state of individuals, particularly in considering the short- and long-term impact of having a fracture that fails to heal and drops into a non-union. The aim of this systematic review is to better understand the impact of fracture non-union to physical health and to respective psychological outcomes. Methods: Electronic databases ‘PubMed’, ‘Cochrane’, ‘PsycInfo’, ‘Medline’, ‘Embase’, ‘Web of Science’, and ‘CINAHL’ were used. Search terms used were nonunion OR non-union OR “non union” OR “long bone” OR “delayed union” AND “quality of life” OR qol OR depression OR anxiety OR psycholog* OR PTSD OR “post-traumatic stress disorder”. Studies published in the years 1995 to 2018 were included. Two independent reviewers carried out screening and data extraction. Studies were included if (1) participants were adult (human) patients with a traumatic non-union secondary to fracture/s; (2) outcomes measured included physical health and psychological wellbeing (e.g., PTSD, psychological trauma, depression, anxiety, etc.). Studies received emphasis if they compared those outcomes between: (1) The “non-union” group to a normative, matched population and (2) the “non-union group” to the same group after union was achieved. However, studies that did not use comparison groups were also included. Results: Out of the 1896 papers identified from our thorough literature search, 13 met the inclusion criteria. Quality assessment was done by the Methodological Index for Non-Randomized Studies (MINORS). Findings suggested that non-unions had a detrimental impact on physical health, and psychological difficulties often after recovery. Conclusions: Patients who experience a long bone non-union are at risk of greater psychological distress and lower physical health status. There is a need for early identification of psychological distress in patients with fracture non-unions and psychological provision should become part of the available treatment.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Physical Health and Psychological Outcomes in Adult Patients with Long-Bone Fracture Non-Unions: Evidence Today

Johnson

Igoe

Kleftouris

et al. 2019

JCM

View full text Add to dashboard Cite

show abstract

“…Despite of rapid progress in orthopaedic diagnosis and treatment, there still remains a nearly 5% incidence of limb nonunion. 1 As a result of its long duration, high costs and poor long-term prognosis, 2 limb nonunion often greatly impacts on patients, physicians and the healthcare system as a whole. In 2014, the Department of Orthopaedic Surgery, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi Province, China proposed to treat limb nonunion using structural autogenous ilium grafting combined with a locking plate.…”

Section: Introductionmentioning

confidence: 99%

Treatment of atrophic nonunion via autogenous ilium grafting assisted by vertical fixation of double plates: A case series of patients

Sun

Zhong

et al. 2019

J Int Med Res

View full text Add to dashboard Cite

Objective To investigate the efficacy of the treatment of atrophic nonunion using structural autogenous ilium bone grafting in combination with vertical fixation of double plates. Methods This retrospective study analysed the clinical data from consecutive patients with atrophic nonunion who underwent autogenous ilium grafting in combination with double-plate vertical fixation. The injury type and the bone affected by nonunion, the duration of nonunion and the outcomes following surgery were recorded for all patients. Results The study enrolled 43 patients with atrophic nonunion of the upper and lower limbs: 17 patients with tibial nonunion, 21 with femoral nonunion, four with humeral nonunion and one with radial shaft nonunion. The mean duration of postoperative follow-up was 14.5 months (range, 8–28 months). A total of 43 of 43 patients (100%) achieved a healed nonunion fracture without the occurrence of complications such as infection, fracture of internal fixation or pain in the harvesting site. Comprehensive postoperative assessments of bone healing and function were observed to be good and/or excellent in all 43 patients. Conclusion Structural autogenous ilium grafting used in combination with double-plate vertical fixation can provide a stable structural environment for near optimal bone healing in patients with atrophic nonunion.

show abstract

Principles of Nonunions

Agarwal¹

2017

Nonunions

View full text Add to dashboard Cite

Long-term functional outcome and quality of life after successful surgical treatment of tibial nonunions

Abstract: This study emphasises the long-term negative impact of tibial nonunions on patient QoL, even after successful surgical treatment.

Cited by 16 publications

References 21 publications

Physical Health and Psychological Outcomes in Adult Patients with Long-Bone Fracture Non-Unions: Evidence Today

Physical Health and Psychological Outcomes in Adult Patients with Long-Bone Fracture Non-Unions: Evidence Today

Treatment of atrophic nonunion via autogenous ilium grafting assisted by vertical fixation of double plates: A case series of patients

Principles of Nonunions

Contact Info

Product

Resources

About