The LEG-NUI − Leeds-Genoa Non-Union Index − is a clinical decision rule, which provides
valuable feedback in terms of the risk of developing fracture non-union within 12 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 12 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-NUI not only could revolutionize clinical
management of patients, but also could reduce the social and financial impact of such a
common clinical condition.