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. 2022 Feb 16;119(50):869-875.
doi: 10.3238/arztebl.m2022.0300.

Nonunions and Their Operative Treatment—a DRG-Based Epidemiological Analysis for the Years 2007-2019 in Germany

Freya M Reeh  1 , Sebastian Sachse, Lisa Wedekind, Gunther O Hofmann, Mark Lenz
Affiliations

Nonunions and Their Operative Treatment—a DRG-Based Epidemiological Analysis for the Years 2007-2019 in Germany

Freya M Reeh et al. Dtsch Arztebl Int. .

Abstract

Background: Nonunions, which arise as a complication of fractures, are an impor - tant medical and socio-economic problem. The goal of this study was to analyze nonunions in Germany with respect to the patients' age and sex, the anatomical site of the lesions, and their operative treatment.

Methods: The study was performed on the basis of DRG (diagnosis-related group) data acquired for billing purposes and collected by the German Federal Statistical Office. The administrative frequencies of nonunions and fractures treated in the inpatient setting, broken down by sex and age group, were calculated from the documentation of ICD codes. An investigation was also made of surgical treatments for nonunion, as they were categorized by the German procedure classification (Operationen- und Prozedurenschlüssel, OPS).

Results: The administrative frequency of nonunion was 14.84 per 100 000 persons per year, with a 2% decline in case numbers over the period 2007-2019. Nonunions develop in 2% of fractures. Nonunions affect men more often than women (58% vs. 42%). In men, their incidence as a function of age is highest under age 30; in women, it rises steadily with increasing age. The most common type of surgical treatment is a combination of resection, bone transplantation, and osteosynthesis.

Conclusion: This is the first detailed nationwide study of diagnoses of nonunions in Germany and their surgical treatment. Despite a slow decline in their incidence, nonunions remain an important problem in the inpatient setting. The risk profile for nonunions is sex-, age-, and site-specific.

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Figures

Figure
Figure
Incidence of inpatient cases with nonunion differentiated according to age and sex, age groups expressed in years
eFigure 1a
eFigure 1a
Absolute case numbers of nonunion during the years 2007–2019
eFigure 1b
eFigure 1b
Incidence of nonunion (per 100 000 person-years) during the years 2007–2019
eFigure 2a
eFigure 2a
Surgical procedures for nonunion during the years 2007–2019
eFigure 2b
eFigure 2b
Surgical procedures for nonunion (per 100.000 person-years) during the years 2007–2019
See this image and copyright information in PMC

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