Nonunion and Delayed Fracture Healing: Mechanisms, Risk Prediction, and Revision Strategy

Nonunion and delayed union remain among the most consequential complications in orthopedic trauma, carrying a heavy burden of repeat surgery, prolonged disability, and cost for both patients and health systems. Despite steady advances in fixation technology, a meaningful share of fractures still fail to heal on the expected timeline, and the field lacks a current, consolidated home for research spanning the biology of impaired healing through to the surgical decision-making that follows it.This Research Topic brings together three strands of that problem. The first is mechanistic: what drives the biological failure of fracture repair, including the roles of vascularity, mechanical environment, and progenitor cell dynamics at the fracture site. The second is predictive: models and scoring systems that identify patients at elevated risk of nonunion early enough to change management, provided they are clinically validated rather than exploratory. The third is operative: the surgical strategies used once nonunion is established, from revision fixation to bone grafting and biological augmentation, with a preference for technique-driven and case-based contributions that reflect real decision-making.We welcome Original Research, Reviews, Case Reports, and Systematic Reviews that advance any of these three strands.Biological mechanisms of nonunion and delayed union, including vascular, mechanical, and cellular determinants of impaired fracture healingClinically validated risk stratification and prediction models for nonunionSurgical revision strategy for established nonunion: fixation revision, bone grafting, and biological augmentation techniquesCase-based and technique-focused reports on managing complex or recurrent nonunion Topic editors: Jaimo Ahn, Ramkumar T. Annamalai, Peter Mittwede Source: https://www.frontiersin.org/research-topics/86249/nonunion-and-delayed-fracture-healing-mechanisms-risk-prediction-and-revision-strategy