(ii) Factors contributing to non-union of fractures

SummaryNon-union of a fracture can be caused by various factors. This review summarizes current concepts of systemic conditions (malnutrition, diabetes, nicotine usage, osteoporosis and non-steroidal anti-inflammatory drugs (NSAIDs) usage) and local factors (infection, vascularity, biomechanical instability, poor bone contact, iatrogenic factors and magnitude of injury) that may be of etiological relevance. Key points for assessing non-unions include checking for malnutrition and peripheral neuropathy, advising smoking cessation, avoiding NSAIDs, and identifying clinical and radiological signs of delayed healing at the earliest possible instance. The prevention of non-union is preferable to the treatment of non-union.