Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Sep 3;15(1):377.
doi: 10.1186/s13018-020-01904-2.

Prevalence and influencing factors of nonunion in patients with tibial fracture: systematic review and meta-analysis

Ruifeng Tian  1 , Fang Zheng  1   2 , Wei Zhao  1   3 , Yuhui Zhang  4 , Jinping Yuan  4 , Bowen Zhang  1 , Liangman Li  5
Affiliations
Meta-Analysis

Prevalence and influencing factors of nonunion in patients with tibial fracture: systematic review and meta-analysis

Ruifeng Tian et al. J Orthop Surg Res. .

Abstract

Objective: The aim of this study is to assess the prevalence of nonunion in patients with tibia fracture and the association between influencing factors and tibia fracture nonunion.

Method: A database searches of PubMed, the Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Weipu database, and Wanfang database from inception until June 2019 was conducted. The pooled prevalence, odds ratio (OR), and 95% confidence intervals (CI) were calculated with Stata software.

Results: In this study, 111 studies involving 41,429 subjects were included. In the study of the relationship between influencing factors and tibia fracture nonunion, 15 factors significantly influenced the fracture union, including > 60 years old, male, tobacco smoker, body mass index > 40, diabetes, nonsteroidal anti-inflammatory drugs (NSAIDs) user, opioids user, fracture of middle and distal tibia, high-energy fracture, open fracture, Gustilo-Anderson grade IIIB or IIIC, Müller AO Classification of Fractures C, open reduction, fixation model, and infection.

Conclusion: The prevalence of nonunion in patients with tibia fracture was 0.068 and 15 potential factors were associated with the prevalence. Closed reduction and minimally invasive percutaneous plate osteosynthesis (MIPPO) have the low risks of nonunion for the treatment of tibial fractures.

Keywords: Influencing factors; Nonunion; Prevalence; Systematic review; Tibia fracture.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the study selection process
Fig. 2
Fig. 2
The forest plot of prevalence of tibia fracture nonunion
Fig. 3
Fig. 3
The publication bias of prevalence of tibia fracture nonunion
Fig. 4
Fig. 4
The comparison of MIPO with IMN
See this image and copyright information in PMC

References

    1. Bell A, Templeman D, Weinlein JC. Nonunion of the Femur andTibia: An Update. Orthop Clin North Am. 2016;47(2):365–375. - PubMed
    1. Lu C, Miclau T, Hu D, et al. Ischemia leads to delayed union duringfracture healing: a mouse model. J Orthop Res. 2007;25(1):51–61. - PMC - PubMed
    1. Zura R, Braid-Forbes MJ, Jeray K, et al. Bone fracture nonunion ratedecreases with increasing age: A prospective inception cohort study. Bone. 2017;95:26–32. - PubMed
    1. Zura R, Watson JT, Einhorn T, et al. An inception cohort analysis topredict nonunion in tibia and 17 other fracture locations. Injury. 2017;48(6):1194–1203. - PubMed
    1. Lerner RK, Esterhai JL, Jr, Polomano RC, et al. Quality of lifeassessment of patients with posttraumatic fracture nonunion, chronic refractory osteomyelitis, and lower-extremity amputation. Clin Orthop Relat Res. 1993;295:28–36. - PubMed

MeSH terms

Substances