BibTex format

author = {Stewart, S and Tenenbaum, O and Masouros, S and Ramasamy, A},
doi = {10.1136/bmjmilitary-2019-001375},
journal = {BMJ Military Health},
pages = {271--276},
title = {Fracture non-union rates across a century of war: a systematic review of the literature},
url = {},
volume = {166},
year = {2020}

RIS format (EndNote, RefMan)

AB - IntroductionFractures have been a common denominator of the injury patterns observed over the past century of warfare. The fractures typified by the blast and ballistic injuries of war lead to high rates of bone loss, soft tissue injury and infection, greatly increasing the likelihood of non-union. Despite this, no reliable treatment strategy for non-union exists. This literature review aims to explore the rates of non-union across a century of conflict and war, in order to determine whether our ability to heal the fractures of war has improved.MethodsA systematic review of the literature was conducted, evaluating the rates of union in fractures sustained in a combat environment over a one hundred year period. Only those fractures sustained through a ballistic or blast mechanism were included. The review was in accordance with the Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA). Quality and bias assessment was also undertaken. ResultsThirty studies met the inclusion criteria, with a total of 3232 fractures described across fifteen different conflicts from the period 1919-2019. Male subjects made up 96% of cases, and tibial fractures predominated (39%). The lowest fracture union rate observed in a series was 50%. Linear regression analysis demonstrated that increasing years had no statistically significant impact on union rate.ConclusionFailure to improve fracture union rates is likely a result of numerous factors, including greater use of blast weaponry and better survivability of casualties. Finding novel strategies to promote fracture healing is a key defence research priority, in order to improve the rates of fractures sustained in a combat environment.
AU - Stewart,S
AU - Tenenbaum,O
AU - Masouros,S
AU - Ramasamy,A
DO - 10.1136/bmjmilitary-2019-001375
EP - 276
PY - 2020///
SN - 2633-3767
SP - 271
TI - Fracture non-union rates across a century of war: a systematic review of the literature
T2 - BMJ Military Health
UR -
UR -
UR -
VL - 166
ER -