Advances in the prognosis and treatment of nonunion fracture: current challenges and future directions

Fracture healing is a critical aspect of orthopedic care, with standard treatment protocols successfully healing approximately 85% of fractures. However, approximately 10% of fractures experience delayed healing and 5% progress to nonunion. Despite extensive research over the past century, accurately predicting fracture outcomes at the patient level remains elusive. This variability complicates treatment decisions and underscores the need for improved diagnostic and prognostic tools to better manage fracture care.

This research topic aims to address ongoing challenges in the diagnosis and treatment of both delayed and nonunion fracture healing. Current methodologies to distinguish between normal healing, delayed healing, and nonunion are limited in their predictability and timing, often leading to prolonged periods of uncertainty and potentially suboptimal care. By investigating and sharing innovative strategies, diagnostic tools and prognostic methods, we seek to improve the standard of care for fracture management. Collaborators are encouraged to explore how early and accurate patient-specific prognostication could alter treatment pathways, reduce incremental costs, and improve patient outcomes.

We invite contributions that review various aspects of delayed fracture healing and fracture nonunion with the aim of providing a comprehensive overview of current practices and future possibilities. Manuscripts may include original research, review articles, clinical trials, and case reports. Specific topics for contributions include, but are not limited to:

o Current methodologies for identifying and diagnosing fracture nonunion versus delayed healing in 2024

o Diagnostic tools and approaches used in clinical practice, their application and effectiveness

o Analysis of costs for treating delayed-healing and non-union fractures compared to normal-healing fractures

o Clinicians’ perspectives on ideal solutions to distinguish between normal healing, delayed healing and non-union

o Potential changes in treatment strategies if early differentiation between fracture healing outcomes could be reliably achieved

o Currently used prognostic methods and their reliability beyond watchful waiting

By examining these themes, we aim to promote a deeper understanding of both delayed-healing and non-union fractures and encourage the development of more effective diagnostic and treatment protocols.

Key words: Fracture Pseudogelation, Delayed Fracture Healing, Outcomes of Fracture Healing, Prognostic Tools for Fractures, Diagnosis of Fracture Healing, Treatment of Fracture Healing Fractures, Management of Fracture Care

Important note: All contributions to this research topic must fall within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to refer an out-of-scope manuscript to a more appropriate section or journal at any stage of peer review.

Fracture healing is a critical aspect of orthopedic care, with standard treatment protocols successfully healing approximately 85% of fractures. However, approximately 10% of fractures experience delayed healing and 5% progress to nonunion. Despite extensive research over the past century, accurately predicting fracture outcomes at the patient level remains elusive. This variability complicates treatment decisions and underscores the need for improved diagnostic and prognostic tools to better manage fracture care.

This research topic aims to address ongoing challenges in the diagnosis and treatment of both delayed and nonunion fracture healing. Current methodologies to distinguish between normal healing, delayed healing, and nonunion are limited in their predictability and timing, often leading to prolonged periods of uncertainty and potentially suboptimal care. By investigating and sharing innovative strategies, diagnostic tools and prognostic methods, we seek to improve the standard of care for fracture management. Collaborators are encouraged to explore how early and accurate patient-specific prognostication could alter treatment pathways, reduce incremental costs, and improve patient outcomes.

We invite contributions that review various aspects of delayed fracture healing and fracture nonunion with the aim of providing a comprehensive overview of current practices and future possibilities. Manuscripts may include original research, review articles, clinical trials, and case reports. Specific topics for contributions include, but are not limited to:

o Current methodologies for identifying and diagnosing fracture nonunion versus delayed healing in 2024

o Diagnostic tools and approaches used in clinical practice, their application and effectiveness

o Analysis of costs for treating delayed-healing and non-union fractures compared to normal-healing fractures

o Clinicians’ perspectives on ideal solutions to distinguish between normal healing, delayed healing and non-union

o Potential changes in treatment strategies if early differentiation between fracture healing outcomes could be reliably achieved

o Currently used prognostic methods and their reliability beyond watchful waiting

By examining these themes, we aim to promote a deeper understanding of both delayed-healing and non-union fractures and encourage the development of more effective diagnostic and treatment protocols.

Key words: Fracture Pseudogelation, Delayed Fracture Healing, Outcomes of Fracture Healing, Prognostic Tools for Fractures, Diagnosis of Fracture Healing, Treatment of Fracture Healing Fractures, Management of Fracture Care

Important note: All contributions to this research topic must fall within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to refer an out-of-scope manuscript to a more appropriate section or journal at any stage of peer review.