Variability in the Definition and Perceived Causes of Delayed Unions and Nonunions

• DOI: 10.2106/jbjs.k.01344
• Publication Date: 2012-11-15T20:56:49Z
• Authors: Mohit Bhandari; Katie Fong; Sheila Sprague; Dale Williams; Bradley Petrisor
• Keywords: Demographics

Background: Despite the large number of fracture outcome studies, there remains variability in definitions fracture-healing. It is unclear how orthopaedic surgeons are diagnosing and managing delayed unions nonunions clinical practice. We aimed to explore current opinions with regard defining, diagnosing, treating extremity fractures. Methods: developed a survey using previous literature, key informants field surgery, sample-to-redundancy strategy. Our final contained four sections twenty-nine questions focusing on demographics surgical experience, union, prognostic factors for need trials. The Internet-based follow-up e-mails were continued until our priori sample size minimum 320 completed eligible responses collected. Results: Three hundred thirty-five survey. typical respondent was North American, male surgeon or consultant over age thirty years who had trauma fellowship training, worked an academic practice, supervised residents, more than six experience injuries. Most endorsed lack standardization (73%) (55%); almost all agreed that defining union nonunion should be done basis both radiographic criteria (88%). respondents believed degree soft-tissue injury (approximately 93%), smoking history 82%), vascular disease 76%) increased risk healing complications. Conclusions: Surgeons use similar define assess nonunions, but consensus nonunion. future randomized trials strongly endorsed.