LEG-NUPS

The LEG-NUPS − Leeds-Genoa Non-Union Predicting Score − is a clinical decision rule, which provides valuable feedback in terms of the risk of developing fracture non-union within six weeks after initial fixation of a fracture of the femoral or tibial shaft.

This clinical decision rule can assist surgeons with the early-diagnosis of a non-union and help them to consider early re-operation.

Non-union, being one of the most common post-fracture fixation complications, represents a major setback for patients and their families. Moreover, its management is associated with increased costs to the health care system. The direct costs, related to treatment, monitoring and follow up, are just a part of the total amount also consisting of indirect costs (inactivity of patients, absence from work and loss of productivity) that this major disease carries along.

Predicting non-union early, typically within 6 weeks after surgical fixation, and guiding the surgeon to intervene early, could therefore be helpful both for the patient and the health care system. Such an approach would result to a faster patient recovery, with an early return to work and normal activities, reducing significantly the cost implications. From this perspective the development of a clinical decision rule, which could assist the orthopaedic surgeons with the early diagnosis and the decision making of an early re-intervention, can be of great importance to providers of health care. The LEG-NUPS not only could revolutionise clinical management of patients, but also could reduce the social and financial impact of such a common clinical condition.

Illustrations created by Martina Portunato.