26 papers · updated 2026-09-26 · Orthopaedic Trauma · All topics
The newest papers on fracture nonunion from the orthopaedic journals The Reduction reads, newest first, each with a one-line summary. The list is drawn from the digest’s archive and refreshed every week.
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Surgical reconstruction of symptomatic scapular neck/body malunions and nonunions achieved universal union and significantly improved DASH scores, flexion, and abduction, though about a quarter needed further surgery.
Musculoskeletal simulation of gait data in 13 tibial shaft fracture patients showed nonunion cases had greater limb asymmetry in push-off moment, joint forces, and plantar flexor muscle forces than those who healed.
In a cohort of 34 nonunion patients, percutaneous fibular graft harvesting reduced pain, blood loss, and peroneal nerve injury compared to open harvesting while achieving comparable union rates.
The Sarcophagus technique combining intramedullary nailing with circumferential cortical strut allograft achieves 87.5% union rate in humeral shaft nonunion with favorable functional recovery and minimal complications.
Testosterone replacement therapy increases nonunion and revision risks in male patients undergoing lower extremity fracture fixation.
Radiographic Scaphoid Waist Index and Nonunion After Scaphocapitate Fusion for Kienböck Disease.
In a small retrospective cohort, lower scaphoid waist index trended toward higher nonunion risk after scaphocapitate fusion for Kienböck disease, but findings were imprecise and hypothesis-generating only.
One-stage repair of infected humeral nonunion after failed ORIF achieved union in 87% of patients, though one in three needed unplanned reoperation for infection or nonunion.
Among nonunion repairs classified by FRI criteria, septic nonunions had worse union rates and higher postoperative infection risk than aseptic or occult-infected nonunions, which performed similarly well.
Prospective study of 39 patients found all-arthroscopic curettage and nonvascularized bone grafting achieved 94.8% union in scaphoid nonunion with good function, though smokers had worse outcomes.
In THA with subtrochanteric osteotomy for Crowe IV DDH, autogenous bone plate wiring improved union rates versus stem press-fit alone, with poor canal fill/cortical apposition and older age as key nonunion risk factors.
Outcomes of Distal Radius Autograft in Adolescent Scaphoid Nonunion Repair.
In adolescent scaphoid nonunions, ORIF with distal radius autograft achieved union in all cases (94% by 6 months) with improved carpal alignment and good return to activity, supporting this as an effective treatment.
Four-corner and lunocapitate fusions show similar outcomes; lunocapitate preserves function better but has higher complication rates requiring further study.
Scaphoid nonunion fixed with nonvascularized autograft healed in 95%, with no difference between cancellous and corticocancellous graft, and bridging bone on early CT reliably predicts union.
Approach to Femoral Shaft Nonunions: Diagnosis and Management.
This review outlines evidence-based diagnostic workup and management strategies for femoral shaft nonunions, which occur in 2–6% of cases despite high union rates with IM nailing.
Arthroscopic bone grafting in scaphoid fracture nonunion: Is it a universal solution?
This review finds arthroscopic bone grafting for scaphoid nonunion achieves union rates and times comparable to open surgery regardless of smoking, chronicity, or fracture location, though deformity correction may be inferior.
The sole use of stem cells in treating fracture nonunion: a scoping review.
This scoping review finds evidence for sole mesenchymal stem cell therapy in fracture nonunion is promising but inconsistent and inconclusive, highlighting the need for standardized study methodologies.
Bone Graft and Fixation Options in the Surgical Management of Scaphoid Nonunion.
Review outlines bone graft and fixation choices for scaphoid nonunion, guiding selection of nonvascularized, vascularized, or osteochondral grafts based on proximal pole viability and deformity.
Distal Radius Nonunions: A Rare Entity?
Reviews the rare entity of distal radius nonunion, its risk factors, and surgical treatment options ranging from ORIF with bone grafting to total wrist arthrodesis.
Scaphoid Nonunions: Local Vascularized Bone Flaps.
Review article on using local vascularized bone flaps for scaphoid nonunion, noting they avoid microsurgical anastomosis and can achieve high union rates in select patients.
Forearm Nonunions-From Masquelet to Free Vascularized Bone Grafting.
This article addresses evaluation and surgical management strategies—from Masquelet technique to free vascularized bone grafting—for forearm nonunions and malunions.
Traditional Bone Grafting in Scaphoid Nonunion.
Nonvascularized bone grafting remains an effective option for scaphoid waist and proximal pole nonunions when combined with adequate debridement, length restoration, and stable fixation.
Scaphoid fracture and nonunion: new directions.
This review covers modern management of acute scaphoid fractures and nonunion, noting a trend toward dual-screw fixation and favoring two screws without bone graft even with humpback deformity.
Scaphoid waist nonunion treatment with slight lengthening, bone graft, and K-wire fixation without compression achieves good union rates.
Treatment of upper extremity palsies, gunshot wounds and scaphoid nonunion: my preferred approaches.
An expert opinion piece outlines the author's preferred surgical strategies for treating upper extremity nerve palsies, gunshot wound injuries, and scaphoid nonunion.
Scaphoid Nonunion Vascularized Bone Grafting in 2021: Is Avascular Necrosis the Sole Determinant?
Scaphoid nonunion treatment decisions should consider multiple risk factors beyond avascular necrosis, including nonunion location, duration, and previous surgery, to guide vascularized bone graft use.
Revision surgery for non-union in adult spinal deformity.
Successful revision surgery for adult spinal deformity pseudoarthrosis requires correcting alignment, restoring anterior column support, and achieving solid fixation; outcomes are generally satisfactory when these goals are met.
The Critical Size Defect as an Experimental Model for Craniomandibulofacial Nonunions
Critical size defects in animal calvaria and mandibles model maxillofacial nonunions; hierarchy of animal models from rat to monkey calvaria to dog and monkey mandibles recommended for bone repair research.
Osteogenic Protein-1 (Bone Morphogenetic Protein-7) in the Treatment of Tibial Nonunions
A randomized trial found rhOP-1 (BMP-7) achieved healing rates comparable to autogenous bone graft for tibial nonunions, without donor-site morbidity.
A new vascularized bone graft for scaphoid nonunion
Vascularized distal dorsoradial radius bone graft enables scaphoid nonunion healing with reduced immobilization time compared to conventional techniques.
The effect of avascular necrosis on Russe bone grafting for scaphoid nonunion
In 45 scaphoid nonunion patients, Russe bone grafting succeeded in 92% with good proximal pole vascularity but failed in all cases of true avascular necrosis, determined intraoperatively by punctate bleeding.
A Review of Ankle Arthrodesis: Predisposing Factors to Nonunion
Reviewing 78 ankle fusions over 15 years, nonunion was linked to fracture type, avascular necrosis, infection, major comorbidities, and open injury, but not age or prior hindfoot fusion.
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