Fracture nonunion in long bones: A literature review of risk factors and surgical management

Injury. 2021 Jun:52 Suppl 2:S3-S11. doi: 10.1016/j.injury.2020.11.029. Epub 2020 Nov 11.


Nonunion following a long bone fracture causes considerable morbidity when it occurs. Risk factors depend on specific fractures but there is a complex interplay of injury severity, comorbidities, patient medication and infection. The majority of nonunions occur after long bone fractures with the tibia, femur, forearm, humerus and clavicle predominating. Despite interest in the biological augmentation of fracture healing, the majority of nonunions can be effectively managed with conventional surgical techniques. In this review we present a review of risk factors for nonunion and the outcome following surgical management.

Keywords: delayed union; diaphyseal; nonunion.

Publication types

  • Review

MeSH terms

  • Clavicle
  • Fracture Healing
  • Fractures, Bone* / diagnostic imaging
  • Fractures, Bone* / surgery
  • Fractures, Ununited* / diagnostic imaging
  • Fractures, Ununited* / surgery
  • Humans
  • Retrospective Studies
  • Risk Factors