{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T11:29:21Z","timestamp":1774351761464,"version":"3.50.1"},"reference-count":72,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T00:00:00Z","timestamp":1709164800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The aim of this study was to evaluate detection rates and risk factors for unsuspected proof of bacteria, as well as clinical and radiologic outcomes following femoral shaft nonunion without clinical signs of infection treated by a single-stage surgical revision procedure including reamed intramedullary exchange nailing. Methods: A retrospective cohort study was performed in a European level I trauma center between January 2015 and December 2022. Fifty-eight patients were included who underwent reamed intramedullary exchange nailing as a single-step procedure for surgical revision of posttraumatic diaphyseal femoral nonunion without any indications of infection in medical history and without clinical signs of local infection. Clinical details of the patients were analyzed and functional and radiologic long-term outcomes were determined. Results: In all patients, with and without proof of bacteria osseous, healing could be observed. The physical component summary of the SF-12 demonstrated significantly better results at least one year after the final surgical revision in case of a negative bacterial culture during exchange nailing. Conclusions: Clinical long-term outcomes demonstrated a trend towards better results following femoral shaft nonunion revision if there was no evidence for the presence of low-grade infected nonunion. In this case, a single-stage surgical procedure may be recommended.<\/jats:p>","DOI":"10.3390\/jcm13051414","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T02:59:39Z","timestamp":1709175579000},"page":"1414","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Long-Term Outcomes Following Single-Stage Reamed Intramedullary Exchange Nailing in Apparently Aseptic Femoral Shaft Nonunion with Unsuspected Proof of Bacteria"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5668-8831","authenticated-orcid":false,"given":"Simon","family":"Hackl","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery, BG Unfallklinik Murnau, 82418 Murnau, Germany"},{"name":"Institute for Biomechanics, Paracelsus Medical University, 5020 Salzburg, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6308-8378","authenticated-orcid":false,"given":"Christian","family":"von R\u00fcden","sequence":"additional","affiliation":[{"name":"Institute for Biomechanics, Paracelsus Medical University, 5020 Salzburg, Austria"},{"name":"Department of Trauma Surgery, Orthopedics and Hand Surgery, Weiden Medical Center, 92637 Weiden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Trenkwalder","sequence":"additional","affiliation":[{"name":"Institute for Biomechanics, Paracelsus Medical University, 5020 Salzburg, Austria"},{"name":"Institute for Biomechanics, BG Unfallklinik Murnau, 82418 Murnau, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena","family":"Keppler","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, BG Unfallklinik Murnau, 82418 Murnau, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Hierholzer","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Perl","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Friedrich-Alexander University Erlangen-N\u00fcrnberg, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1186\/s13018-023-04232-3","article-title":"Risk factors and healthcare costs associated with long bone fracture non-union: A retrospective US claims database analysis","volume":"18","author":"Vanderkarr","year":"2023","journal-title":"J. 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