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Do Successful Surgical Results after Operative Treatment of Long-bone Nonunions Correlate with Outcomes?

  • Original Article
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Clinical Orthopaedics and Related Research®

Abstract

There has been increased emphasis on validated, patient-reported functional outcomes after orthopaedic interventions for various conditions. The few reports on these types of outcomes after treatment of fracture nonunions are limited to specific anatomic sites, limited by small numbers, and retrospective. To determine whether successful healing of established long-bone nonunions resulted in improved functional outcomes and reduction in patient-reported pain scores, we prospectively followed 80 patients. These patients had a mean of 1.4 surgical procedures before enrollment and a mean of 18 months had elapsed from previous surgery until enrollment. Baseline data and functional scores were obtained before intervention. Seventeen of the 80 patients (21%) had positive intraoperative cultures. At a mean of 18.7 months (range, 12–36 months), 72 (90%) nonunions had healed. Patients with healed nonunions scored better on the Short Musculoskeletal Functional Assessment. Pain scores among all patients improved compared with baseline, but to a greater degree in patients who achieved healing by final followup. Our data suggest improvement in pain scores is seen in all patients after surgery, whereas successful internal fixation leads to improved function.

Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Roy I. Davidovitch MD, Christopher Bechtel, BS, and Leon Rybak MD, for help with preparation of this manuscript.

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Authors and Affiliations

  1. NYU Hospital for Joint Diseases, 301 E 17th Street 1402, New York, NY, 10003, USA

    Kenneth A. Egol MD, Allison B. Spitzer BA, Michael Walsh PhD & Nirmal C. Tejwani MD

  2. Jamaica Hospital Medical Center, Jamaica, NY, 11418, USA

    Kenneth A. Egol MD

  3. Albert Einstein School of Medicine, New York, NY, USA

    Konrad Gruson MD

Authors
  1. Kenneth A. Egol MD
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  2. Konrad Gruson MD
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  3. Allison B. Spitzer BA
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  4. Michael Walsh PhD
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  5. Nirmal C. Tejwani MD
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Correspondence to Kenneth A. Egol MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at NYU Hospital for Joint Diseases and The Jamaica Hospital Medical center.

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Egol, K.A., Gruson, K., Spitzer, A.B. et al. Do Successful Surgical Results after Operative Treatment of Long-bone Nonunions Correlate with Outcomes?. Clin Orthop Relat Res 467, 2979–2985 (2009). https://doi.org/10.1007/s11999-009-0883-x

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  • DOI: https://doi.org/10.1007/s11999-009-0883-x

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