Early prediction of non union tibia from post operative follow up 3rd month radiographic union status of tibial fracture (rust ) score: A systematic review and meta analysis

Author(s): Govind Kumar Gupta1, Subhankar Manda1, Sudha Rani2, Tushar Kumar3, Pancham Prasad4, Ratnajeet Chakraborty4
1Department of Orthopaedics, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India, 834009.
2Department of Anatomy, Sheikh Bhikhari Medical College, Hazaribagh, Jharkhand. India.
3Department of Anesthesiology – Trauma Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India, 834009.
4Department of Orthopaedics, Rajendra Institute of Medical sciences, Ranchi, Jharkhand. India.
Copyright © Govind Kumar Gupta, Subhankar Manda, Sudha Rani, Tushar Kumar, Pancham Prasad, Ratnajeet Chakraborty. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: Early prediction of the non-union tibia by the RUST score (Radiographic union score for tibia fracture) at three months postoperatively. That will help with early detection of non-union, intervene to treat the non-union and help get back to normal daily life.
Materials and method: Systematic search was done in an electronic database (Google Scholar, PubMed , Chochrane library ) for articles published till 5th January 2022 investigating RUST score as a predictor for non union tibia . The new castle Ottowa scale (NOS) was used to determine risk of bias for each study.
Result: The search turned up 81 records. The final sample included three trials ( 2 cohorts and 1 case control study) involving 510 patients. Statistical analysis showed that if RUST score is >6 at 3rd month then there is 7.12 times more chance for union( OR -7.12, 95% CI-4.06 to 12.49). This meta analysis suggests that the RUST score at 3rd month has the potential to provide an early prediction of tibial non-union. Radiographic union scale in tibial fracture (RUST), the Newcastle ottowa scale (NOS), fracture tibia, non-union, intramedullary interlocking nail.

Keywords: Ocular surface disorder; Diabetes mellitus; Tertiary care center.