Nonunion and Reoperation After Internal Fixation of Proximal Femur Fractures: A Systematic Review

Nonunion after fixation of a proximal femur fracture is associated with increased disability, pain, and cost to both patient and health care system. Understanding the effect of fixation method and fracture pattern on healing is important to optimize healing. The authors evaluated surgical healing, nonunion rate, and reoperation rate after internal fixation of proximal femur fracture, especially since the year 2000. They performed a systematic review of all published records from PubMed, Embase, and the Cochrane Review system. The burden of proximal femoral fracture extends beyond acute disability, as it carries a high risk of long-term morbidity and mortality. Choice of fixation method for high-risk fractures is critical to reduce nonunion and reoperation rates. [Orthopedics. 2019; 42(2):e162-e171.].