← Articles

Marshall et al: Delayed union, non-union and mal-union in 442 dogs
Veterinary Surgery 7, 2022

Delayed union, non-union and mal-union in 442 dogs

🔍 Key Findings

  • Delayed union occurred in 13.9% of fractures; non-union in 4.6%; mal-union in 0.7%
  • Major implant failure increased odds of delayed or non-union by 12.9×
  • Surgical site infection increased risk 3.2×; bone grafting (any type) was also associated (OR 3.3)
  • Comminuted fractures had 4.2× greater odds of delayed or non-union
  • Older age increased risk, with odds increasing by 21% per year
  • Radius and ulna fractures in toy breeds were not high risk, contrary to historical belief
  • Most non-unions required revision surgery with rhBMP-2 or autograft to achieve union
  • Ilium fractures showed 0% delayed/non-union — possibly due to robust muscle envelope

Simini Surgery Review Podcast

How critical is this paper for crushing the Boards?

🚨 Must-know. I’d bet on seeing this.

📚 Useful background, not must-know.

💤 Skip it. Doubt it’ll ever show up.

Thanks for the feedback!
‍We'll keep fine-tuning the articles vault.
Oops — didn’t go through.
‍Mind trying that again?
Flag for reviewSuggest findings
← Articles

Marshall et al: Delayed union, non-union and mal-union in 442 dogs
Veterinary Surgery 7, 2022

🔍 Key Findings

  • Delayed union occurred in 13.9% of fractures; non-union in 4.6%; mal-union in 0.7%
  • Major implant failure increased odds of delayed or non-union by 12.9×
  • Surgical site infection increased risk 3.2×; bone grafting (any type) was also associated (OR 3.3)
  • Comminuted fractures had 4.2× greater odds of delayed or non-union
  • Older age increased risk, with odds increasing by 21% per year
  • Radius and ulna fractures in toy breeds were not high risk, contrary to historical belief
  • Most non-unions required revision surgery with rhBMP-2 or autograft to achieve union
  • Ilium fractures showed 0% delayed/non-union — possibly due to robust muscle envelope

Simini Surgery Review Podcast

Know What Matters in the Literature - and Why

We distill peer-reviewed surgical studies into clinically relevant summaries and
exam-style questions, so you can make informed decisions with confidence.

Free Access. No Spam. Just Smarter Surgical Learning

Multiple Choice Questions on this study

In Marshall 2022 et al., what **effect did bone grafting** have on delayed or non-union outcomes?

A. Decreased odds of delayed union
B. No effect on outcome
C. Increased odds (OR 3.32) of delayed or non-union
D. Only increased risk if autograft was used
E. Only significant in open fractures

Answer: Increased odds (OR 3.32) of delayed or non-union

Explanation: Bone graft use was associated with a 3.32× increase in risk, likely reflecting selection bias.
In Marshall 2022 et al., on delayed and non-union risk, what was the **strongest predictor** of delayed or non-union in canine fractures?

A. Comminuted fracture
B. Surgical site infection
C. Bone graft use
D. Implant failure
E. Open fracture

Answer: Implant failure

Explanation: Implant failure had an OR of 12.94 — the strongest risk factor identified.
In Marshall 2022 et al., on fracture healing in dogs, how did **radius and ulna fractures in toy breeds** perform regarding delayed or non-union?

A. Were significantly more likely to result in non-union
B. Were significantly more likely to require bone grafting
C. Were no more likely to result in delayed or non-union
D. Were always treated with external coaptation
E. Were excluded from the study

Answer: Were no more likely to result in delayed or non-union

Explanation: The study found no increased odds of poor healing in toy breed radius/ulna fractures.
In Marshall 2022 et al., which **dog-related factor** significantly increased the odds of delayed or non-union?

A. Body weight
B. Breed
C. Sex
D. Age
E. BCS (body condition score)

Answer: Age

Explanation: Odds increased 21% per year of age (OR 1.21 per year).
In Marshall 2022 et al., on fracture healing outcomes, what was the **prevalence of non-union** among the 461 fractures reviewed?

A. 13.9%
B. 4.6%
C. 0.7%
D. 21.1%
E. 8.8%

Answer: 4.6%

Explanation: The authors reported non-union in 21 of 461 fractures (4.6%).

Access the full library of surgical summaries and exam-style questions.

Get Instant Access

Educational content developed independently and supported by Simini.

The maker of Simini Protect Lavage.

Review More Key Summaries from this Veterinary Surgery Journal Issue

Ritson

 et al: 

Ex vivo comparative evaluation of feline hilar lung lobectomy using linear stapler, pretied ligature loop, and double-shank titanium clips

Dobberstein

 et al: 

Primary repair of nonsteroidal anti‐inflammatory drug‐associated full thickness gastrointestinal ulcers in 11 dogs

Davies

 et al: 

Lymphaticovenous anastomosis of the caudal thoracic duct to the azygous vein: A feline cadaver study

Kurogochi

 et al: 

Saline‐based modified del Nido cardioplegia versus multidose St. Thomas cardioplegia in canine mitral valve repair: A randomized controlled trial

Dalton

 et al: 

Minimally invasive repair of acetabular fractures in dogs: Ex vivo feasibility study and case report

Something off with this article?
Tell us what needs fixing—drop your note below.
Cancel
Thanks for flagging this!
We’ll review your note as soon as possible.
Oops! Something went wrong while submitting the form.
Anything to add to this article?
Know a finding or detail we missed? Share it below.
Cancel
Thanks for the suggestion!
We’ll review it as soon as possible.
Oops! Something went wrong while submitting the form.