Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! By
Risk Factors for Non-Union After Distal Phalangeal Fractures of the Hand: A Nationwide Study in the Us Publisher



S Esmaeili SINA ; Mp Pashazadeh Mohammad PARSA ; F Kanaani Nejad FATEMEH ; A Shirinezhad AMIRHOSSEIN ; J Adolf JAKOB ; Ah Hoveidaei Amir HUMAN ; Jd Conway Janet D
Authors

Source: Archives of Orthopaedic and Trauma Surgery Published:2025


Abstract

Introduction: This study aims to identify risk factors associated with non-union following distal phalangeal fractures of the hand. Materials and methods: This retrospective cohort study utilized the PearlDiver database (2010–2022) to identify adult patients with distal phalangeal fractures and at least one year of follow-up. Patients were categorized into union and nonunion groups using ICD and CPT codes. Risk factors for nonunion were assessed by analyzing demographics, comorbidities, fracture characteristics (open vs. closed, displaced vs. nondisplaced, number of fractured fingers), and treatment type (surgical: open/percutaneous vs. non-surgical: closed) using chi-square tests, t-tests, and multivariable logistic regression (P < 0.05 was considered significant). Results: Nonunion was reported among 3,378 (3.0%) of the 114,667 patients with distal phalanx fractures. Nonunion patients were older and had greater rates of tobacco use, alcohol abuse, obesity, soft tissue injury, and surgical site infection. Fracture of the thumb was less likely to be associated with nonunion compared with other fingers. Open fracture, compared to closed fracture, and surgical treatment, compared to non-surgical treatment, were among the independent predictors of nonunion. Conclusions: This study identifies key risk factors for nonunion in distal phalangeal fractures of the hand, including older age, obesity, tobacco use, alcohol abuse, displaced fractures, and surgical treatment. Addressing modifiable risk factors, such as smoking cessation and weight management, may help reduce the risk of nonunion. Further prospective studies are warranted to better understand additional contributors to bone healing. © 2025 Elsevier B.V., All rights reserved.
Related Docs
View other Related Docs
1. Global Trends of Hand and Wrist Trauma: A Systematic Analysis of Fracture and Digit Amputation Using the Global Burden of Disease 2017 Study, Injury Prevention (2020)
2. Treatment of Distal Radius Fracture Nonunion With Posterior Interosseous Bone Flap, Iranian Red Crescent Medical Journal (2016)
3. Isolated Displaced Capitate Fracture: A Case Report, Trauma Monthly (2018)
Experts (# of related papers)
View all Related Experts
Reza Shahriar Kamrani (4)
Mohammad Hossein Nabian (2)
Other Related Docs
4. A Systematic Review and Meta-Analysis of Prospective Cohort Studies on the Association Between Alcohol Intake and Risk of Fracture, Critical Reviews in Food Science and Nutrition (2022)
5. Forearm As a Valuable Source of Vascularized Bone Graft for the Distal Humerus, Journal of Shoulder and Elbow Surgery (2018)
6. Human Thumb Consists of Three Phalanges and Lacks Metacarpal? a Morphometric Study on the Long Bones of the Hand, Surgical and Radiologic Anatomy (2022)
7. Treatment of Nonunion of Forearm Bones Using Radial Forearm Bone Flap, Trauma Monthly (2015)
8. The Effects of Adding Splint Use to Corticosteroid Injection for the Treatment of Trigger Finger: A Randomized Controlled Trial, Musculoskeletal Care (2022)
9. Research Paper: The Psychometric Features of the Patient-Rated Wrist; Evaluation in Iranians With Scaphoid or Distal Radius Fracture, Iranian Rehabilitation Journal (2021)
10. Outcomes of the Pin and Plate Technique in Complex Fractures and Nonunions of Distal Humerus, Archives of Bone and Joint Surgery (2023)
11. Association of Distal Radial Fracture With Comorbidities: Model Development and Validation, Injury (2024)
12. Illicit Drug Abuse and Complexity of Tibial Shaft Fracture Based on Ao/Ota Classification: Is There Any Connection?, Journal of Experimental Orthopaedics (2024)
13. Persian Fixation - a Novel Surgical Method for Intra-Articular Distal Radius Fractures, Journal of Hand Surgery Asian-Pacific Volume (2023)
14. Modified Tension Band Wiring in Adult Distal Humeral Fracture Types A2 and C1, Archives of Bone and Joint Surgery (2019)
15. Occupational Performance 1 Year After a Distal Radius Fracture From the Perspective of the International Classification of Functioning, Disability and Health, American Journal of Occupational Therapy (2023)
16. Global, Regional, and National Burden of Bone Fractures in 204 Countries and Territories, 1990–2019: A Systematic Analysis From the Global Burden of Disease Study 2019, The Lancet Healthy Longevity (2021)
17. Humeral Shaft Fracture: A Randomized Controlled Trial of Nonoperative Versus Operative Management (Plate Fixation), Orthopedic Research and Reviews (2019)
18. Weekend Open Reduction and Internal Fixation of Distal Radius Fractures Associated With Higher Complication and Readmission Rates: A Nationwide Analysis of Two Hundred and Sixty Six Thousand, Three Hundred and Seventy Eight Patients, International Orthopaedics (2025)