TY - JOUR
T1 - Do successful surgical results after operative treatment of long-bone nonunions correlate with outcomes?
AU - Egol, Kenneth A.
AU - Gruson, Konrad
AU - Spitzer, Allison B.
AU - Walsh, Michael
AU - Tejwani, Nirmal C.
PY - 2009/11
Y1 - 2009/11
N2 - 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.
AB - 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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U2 - 10.1007/s11999-009-0883-x
DO - 10.1007/s11999-009-0883-x
M3 - Article
C2 - 19437084
AN - SCOPUS:70449532318
SN - 0009-921X
VL - 467
SP - 2979
EP - 2985
JO - Clinical orthopaedics and related research
JF - Clinical orthopaedics and related research
IS - 11
ER -