Fracture nonunion and delayed union

Delayed union and non-union of fractures exist in the pediatric population. Fracture healing requires the synergistic collaboration of mechanical support and robust biological processes to allow endochondral ossification, reestablishment of bone continuity, and subsequent remodeling to strong lamellar bone. Failure of either mechanical stability or biology may manifest as delayed fracture healing. While early recognition of potential metabolic and pharmacologic risk factors may be addressed by pre-emptive treatment using nutritional and vitamin D supplements, definitive treatment of established non-union requires a comprehensive approach. Delayed unions and non-unions are more common in adult bone but can also occur in pediatric bone Fracture healing requires synergistic collaboration of mechanical support and robust biological processes; treatment of non-unions should address both the biological and mechanical factors Vitamin D is an integral component of calcium absorption and bone health