Universal Long Bone Nonunion Classification

Leonid N Solomin; Anton A Semenistyy; Artem V Komarov; Vladimir V Khominets; Gerard A Sheridan; S Robert Rozbruch

doi:10.5005/jp-journals-10080-1597

Universal Long Bone Nonunion Classification

Strategies Trauma Limb Reconstr. 2023 Sep-Dec;18(3):169-173. doi: 10.5005/jp-journals-10080-1597.

Authors

Leonid N Solomin¹, Anton A Semenistyy², Artem V Komarov³, Vladimir V Khominets³, Gerard A Sheridan⁴, S Robert Rozbruch⁴

Affiliations

¹ Department of Orthopedic Surgery, Vreden National Research Orthopedic Centre, Saint Petersburg, Russian Federation.
² Department of Orthopedics and Traumatology, Faculty of Medicine, Medical University of Sofia, Sofia, Bulgaria.
³ Department of Military Traumatology and Orthopedics, S. M. Kirov Military Medical Academy, Saint Petersburg, Russian Federation.
⁴ Department of Orthopedic Surgery, Hospital for Special Surgery, New York, United States.

Abstract

Aim and background: The management of bone union disorders is a complex problem in orthopaedics, requiring a reliable and comprehensive classification system for accurate diagnosis and treatment. Despite advances in understanding pathophysiology, diagnosis, and treatment in this area, there is no generally accepted classification system. The aim of our work was to create a comprehensive classification, which will systemize the vast majority of bone union disorders, underline their differences and form the basis for their treatment.

Methods: The key criteria for nonunion evaluation and treatment were identified based on the conducted literature review: Time from the initial event (delayed union or nonunion), location, type of pathology (A, Hypertrophic; B, Normotrophic; C, Oligotrophic) and the presence of hardware. Based on these criteria the ULBNC has been developed. Atrophic nonunions were excluded from this classification as they are considered segmental bone defects with special classification.

Results: The ULBNC is based on the same principles of coding as the "gold standard" AO/OTA Fractures Classification system with alpha-numeric coding "from simple to complex." The choice of treatment method depends on the type, group, and subgroup of the nonunion as described.

Conclusion: Universal Long Bone Nonunion Classification (ULBNC) is an alphanumeric system that describes the localization, type of pathology and morphologic characteristics of a nonunion. The use of ULBNC in practice and research will optimize and standardize the treatment of various types of bone healing disorders and eventually improve clinical outcomes.

How to cite this article: Solomin LN, Semenistyy AA, Komarov AV, et al. Universal Long Bone Nonunion Classification. Strategies Trauma Limb Reconstr 2023;18(3):169-173.

Keywords: Aseptic nonunion; Atrophic nonunion; Bone defect; Bone loss; Classification; Hypertrophic nonunion; Nonunion; Normotrophic nonunion; Oligotrophic nonunion; Pseudarthrosis.

Publication types

Review