{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T19:32:26Z","timestamp":1788550346351,"version":"build-2803163510"},"reference-count":63,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2020,3,1]],"date-time":"2020-03-01T00:00:00Z","timestamp":1583020800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n            <jats:title>Abstract<\/jats:title>\n            <jats:p>The occurrence of both nonunion and fracture-related infection provides challenges for both the patient and the treating orthopaedic surgeon, with the potential need for complex reconstructive procedures to achieve union and\/or eradicate infection. In addition to addressing the multiple different factors that often contribute to nonunion, surgeons are often forced to deal with difficult hardware issues at the time of revision surgery including infected hardware, loose or failing hardware, malaligned hardware, or inappropriate hardware constructs. This article reviews common causes of nonunions with emphasis on infection management and provides indications and techniques for hardware removal in the context of an algorithmic approach to nonunion management with illustrative case examples.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/oi9.0000000000000055","type":"journal-article","created":{"date-parts":[[2020,3,30]],"date-time":"2020-03-30T00:11:11Z","timestamp":1585527071000},"page":"e055","source":"Crossref","is-referenced-by-count":28,"title":["Hardware considerations in infection and nonunion management"],"prefix":"10.1097","volume":"3","author":[{"given":"Graeme","family":"Hoit","sequence":"first","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marissa","family":"Bonyun","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Nauth","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, University of Toronto"},{"name":"Department of Orthopaedic Surgery, St. Michaels Hospital, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,3]]},"reference":[{"key":"R1-20231103","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1080\/17453674.2017.1321351","article-title":"The risk of non-union per fracture: current myths and revised figures from a population of over 4 million adults","volume":"88","author":"Mills","year":"2017","journal-title":"Acta Orthop."},{"key":"R2-20231103","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1007\/s11999-016-4821-4","article-title":"Will my tibial fracture heal? Predicting nonunion at the time of definitive fixation based on commonly available variables","volume":"474","author":"O\u2019Halloran","year":"2016","journal-title":"Clin Orthop Relat Res."},{"key":"R3-20231103","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1097\/00005131-200207000-00005","article-title":"The treatment of nonunions following intramedullary nailing of femoral shaft fractures","volume":"16","author":"Pihlajamaki","year":"2002","journal-title":"J Orthop Trauma."},{"issue":"(suppl 4)","key":"R4-20231103","doi-asserted-by":"crossref","first-page":"S35","DOI":"10.1016\/S0020-1383(08)70007-X","article-title":"Use of bone morphogenetic proteins for treatment of non-unions and future perspectives","volume":"38","author":"Schmidmaier","year":"2007","journal-title":"Injury."},{"key":"R5-20231103","doi-asserted-by":"crossref","first-page":"273","DOI":"10.5435\/JAAOS-20-05-273","article-title":"Assessment of compromised fracture healing","volume":"20","author":"Bishop","year":"2012","journal-title":"J Am Acad Orthop Surg."},{"key":"R6-20231103","doi-asserted-by":"crossref","first-page":"e1991","DOI":"10.2106\/JBJS.M.01180","article-title":"Tibial nonunion is worse than having a myocardial infarction: Commentary on an article by Mark R. Brinker, M\u2217\u2217D, et al.: \u201cThe devastating effects of tibial nonunion on health-related quality of life\u201d","volume":"95","author":"Kreder","year":"2013","journal-title":"J Bone Joint Surg Am."},{"key":"R7-20231103","doi-asserted-by":"crossref","first-page":"2170","DOI":"10.2106\/JBJS.L.00803","article-title":"The devastating effects of tibial nonunion on health-related quality of life","volume":"95","author":"Brinker","year":"2013","journal-title":"J Bone Joint Surg Am."},{"key":"R8-20231103","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/1471-2474-14-42","article-title":"Tibia shaft fractures: costly burden of nonunions","volume":"14","author":"Antonova","year":"2013","journal-title":"BMC Musculoskelet Disord."},{"issue":"(suppl 2)","key":"R9-20231103","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1016\/j.injury.2014.04.002","article-title":"Delayed union and nonunions: epidemiology, clinical issues, and financial 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