High Occurrence of Long Bone Nonunion : Assessing Significant Biological Risk Factors and Management Results

Background: A comprehensive study evaluated the risk of nonunion per fracture in a population of over four million adults and determined that rates vary depending on patients' risk factors, nonunion rates can reach in excess of 10%. This study aims to address the issue by scrutinizing the demographic characteristics of patients, pinpointing the biological risk factors for long bone nonunion and evaluating the nonunion management effectiveness. Methods: This analytical, observational retrospective cohort study used medical record data from a regional hospital in Surabaya, Indonesia (2020–2023), involving 147 eligible patients. Data were analyzed using logistic regression with a significance level of p < 0.05. Results: Numerous risk factors are associated with nonunion events in long bone fractures of which our study identified four significant ones: smoking habits (AOR: 9.02; 95% CI 4.10-19.81), high-energy injuries (AOR: 3.19; 95% CI 1.53-6.64), anemia (AOR: 2.95; 95% CI 1.47-5.89), and abnormal BMI status (AOR: 2.42; 95% CI 1.22-4.80). Nonunion patient management has a high success rate (87.2%) due to several factors, including adequate pre-operative preparation designated for each patient, regular follow-up schedule, and support from the medical rehabilitation team. Conclusion: Having identified the biological risk factors in the individual case of every patient who experiences fracture is deemed essential to delivering comprehensive management. The second evaluation following the hospital management policy's implementation, confirmed a notable success in nonunion management. Keywords: Fracture, Long bone, Nonunion, Indonesia