Risk factors for non-union in foot and ankle arthrodesis: a population-based case-control study using registry data

Area of Science:

• Orthopedic Surgery
• Biostatistics
• Health Informatics

Background:

• Nonunion is a frequent complication of foot and ankle arthrodesis.
• Identifying risk factors for nonunion is crucial for improving surgical outcomes.

Purpose of the Study:

• To investigate the risk factors associated with nonunion following foot and ankle arthrodesis.
• To compare the incidence of nonunion between different patient groups and surgical factors.

Main Methods:

• Retrospective case-control study utilizing the National Health Insurance Research Database.
• 107 nonunion cases were matched with 428 union controls by age and sex.
• Logistic regression analysis was performed to identify significant risk factors.

Main Results:

• Diabetes mellitus was associated with a 1.71 times higher risk of nonunion (p=0.0278).
• No significant differences in nonunion risk were found based on joint treated, arthritis presence, fixation method, or bone graft use.
• In non-diabetic patients, tarsometatarsal joint arthrodesis showed a 6.51 times higher risk of nonunion compared to ankle arthrodesis (p=0.0256).

Conclusions:

• Diabetes mellitus is a significant risk factor for nonunion in foot and ankle arthrodesis.
• Tarsometatarsal joint arthrodesis presents a higher nonunion risk, particularly in patients without diabetes mellitus.