Table 1

Table illustrating fracture treatment strategies and associated union rates

Author and year of publicationConflictCasesFracture treatmentAverage time to union (weeks)Fracture union rate (%)
Albee and Weigel 191939World War I48BG and IFNS85
Bulkley and Sinclair 191927World War I131NO (suspension and traction)NS77.1
Smith 192040World War I152NO (suspension and traction)NS88.8
Cleveland 194641World War II3190NO (suspension and traction)NS82
Hampton 194642World War II332NS4088.3
Soto-Hall and Horwitz 194643World War II163NO; IFNS87
Bishop et al 194717World War II358BG and IF2088.8
Witschi and Omer 197022Vietnam War84NO (casting); BG20100
Ronen et al 197444Israel–Palestine conflict5EF7.880
Calderwood 197526Northern Ireland conflict151NO (casting±skeletal traction)NS90.9
Weinberg et al 197923Israel–Palestine conflict4BG74.8100
Zinman and Reis 198445Lebanon War45EFNS91.1
Reis et al 199146Israel–Palestine conflict110EF19.784.5
Bhatnagar et al 199247Afghanistan civil war385NSNS88.8
Nicholas and McCoy 199548Northern Ireland conflict12IF23.992.8
Keller 199549Sudanese civil war37NO (casting±skeletal traction); EF6081.1
Has et al 199550Croatian War of Independence215EFNS90.2
 Pukljak 199751Croatian War of Independence196EF±minimal osteosynthesis*2896.9
Atesalp et al 199852Kurdish–Turkish conflict43EF217.293
Atesalp et al 200253Kurdish–Turkish conflict142EFNS93.8
Busić 200624Croatian War of Independence35IF; EFNS100
Lerner et al 200654Israel–Palestine conflict47EF34.890.6
Johnson et al 20071Iraq War and Afghanistan War35NSNS85.7
Weil et al 200755Israel–Palestine conflict117NO (casting); IF; EFNS87
Kuklo et al 200819Iraq War129IF (+bone grafting or BMP); EFNS83.7
Keeling et al 200818Iraq War and Afghanistan War38EF (±bone grating or BMP)31.5792.1
Mathieu et al 201125Iraq War, Afghanistan War, Kosovo war and Ivory Coast civil war16EF26100
Cicvaric et al 201156Croatian War of Independence55EF50.489
Penn-Barwell et al 201320Iraq War and Afghanistan War30NO; IF; EFNS50
Alhammoud et al 201957Syrian civil war404EF21.868.3
  • *Minimal osteosynthesis refers to the osseous fusion of the fibula to the distal tibia.

  • BG, bone grafting; BMP, bone morphogenetic protein; EF, external fixation; IF, internal fixation; NO, non-operative; NS, not specified.