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RISK FACTORS AT NON-UNION OF TIBIAL FRACTURE TREATED WITH INTRAMEDULLARY NAIL.
Vitor Lorens Yulta Abe Puccetti1, Fernando Loureiro de Miranda1, Caio Cesar Nogueira de Figueiredo1
1Universidade de São Paulo, Medical School, Hospital das Clínicas (HC-FMUSP), Institute of Orthopedics and Traumatology, São Paulo, SP, Brazil.
Acta Ortopedica Brasileira
|June 27, 2024
Summary
High-energy trauma and open fractures predict delayed healing in tibial shaft fractures treated with intramedullary nailing (IMN). Postoperative infection and external fixation also increase non-union risk after IMN.
Area of Science:
- Orthopedic surgery
- Trauma surgery
- Bone healing research
Background:
- Tibial shaft fractures are common injuries.
- Intramedullary nailing (IMN) is a standard treatment for tibial shaft fractures.
- Delayed union and non-union remain significant complications impacting patient outcomes.
Purpose of the Study:
- To identify predictors of delayed union at 6 months and non-union at 12 months.
- To analyze factors influencing healing complications after IMN for tibial shaft fractures.
Main Methods:
- Retrospective longitudinal study of 218 patients with tibial shaft fractures treated with IMN.
- Data collected on patient demographics, trauma characteristics, comorbidities, and treatment factors.
- Logistic bivariate regression analysis used to identify predictive factors.
Main Results:
- Delayed union occurred in 28.9% of patients at 6 months.
- Predictors for delayed union included flap coverage, high-energy trauma, open fractures, external fixation, RUST score, and postoperative infection.
- Non-union occurred in 15.6% of patients at 12 months.
Conclusions:
- High-energy trauma is a primary predictor for non-union after IMN of tibial shaft fractures.
- External fixation and postoperative infection are also associated with increased non-union rates.
