The risk of non-union per fracture: current myths and revised figures from a population of over 4 million adults
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Open Access
- 16 May 2017
- journal article
- research article
- Published by Medical Journals Sweden AB in Acta Orthopaedica
- Vol. 88 (4), 434-439
- https://doi.org/10.1080/17453674.2017.1321351
Abstract
Background and purpose — Fracture non-union remains a major clinical problem, yet there are no data available regarding the overall risk of fractures progressing to non-union in a large population. We investigated the rate of non-union per fracture in a large adult population. Methods — National data collected prospectively over a 5-year period and involving just under 5,000 non-unions were analyzed and compared to the incidence of fracture in the same period. Results and interpretation — The overall risk of non-union per fracture was 1.9%, which is considerably less than previously believed. However, for certain fractures in specific age groups the risk of non-union rose to 9%. As expected, these higher rates of non-union were observed with tibial and clavicular fractures, but—less expectedly—it was in the young and middle-aged adults rather than in the older and elderly population. This study is the first to examine fracture non-union rates in a large population according to age and site, and provides more robust (and lower) estimates of non-union risk than those that are frequently quoted.Keywords
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