Skip to main content

MSK & Orthopaedics

Nonunion fracture

A nonunion is a fracture that has stopped healing; causes include poor blood supply, instability, infection and biological factors, and specialist surgery achieves union in most cases.

Key points

The essentials at a glance.

What to look out for, who treats it, and what usually happens next.

  • Persistent pain and movement at the fracture site months after injury

  • Smoking, diabetes, infection and some medications impair bone healing

  • CT confirms whether bridging bone has formed

  • Infection must always be excluded before revision surgery

  • Revision fixation and bone grafting achieve union in the great majority

Understanding it

About Nonunion fracture.

Most fractures heal within months, but some stall: the bone ends fail to bridge, pain persists, and X-rays stop changing - a nonunion. Contributors include a poor blood supply at that site, inadequate stability, gap or infection at the fracture, and patient factors such as smoking, diabetes and vitamin D deficiency.

Assessment includes CT to define the nonunion, blood tests and sampling to exclude low-grade infection. Treatment corrects what stalled the healing - revision fixation for stability, bone grafting for biology, staged surgery for infection - and modern techniques achieve union in most patients. In the UK you can start with your GP: on the NHS, a routine referral to a specialist clinic often means waiting 20–45 weeks or more to be seen, while a private consultant will typically see you within around two weeks, with any tests arranged soon after.

Frequently asked

Common questions about Nonunion fracture.

Quick, plain-English answers to what people ask us most.

  • What is a nonunion fracture?

    A nonunion fracture occurs when a broken bone fails to heal properly within the expected timeframe, leaving a persistent gap or instability at the fracture site despite adequate time for normal healing.

  • What causes a nonunion fracture?

    Causes include inadequate blood supply to the fracture site, infection, insufficient immobilisation, smoking, certain medications, and underlying conditions such as diabetes or osteoporosis that impair normal bone healing.

  • What are the symptoms of a nonunion fracture?

    Symptoms include persistent pain at the fracture site beyond the normal expected healing time, ongoing instability or movement at the fracture, and sometimes visible deformity.

  • Is a nonunion fracture dangerous?

    It's not immediately life-threatening, but it can cause chronic pain, disability and reduced function if not addressed, making treatment important for long-term quality of life.

  • Can a nonunion fracture heal on its own?

    Once truly established as a nonunion, healing without intervention is unlikely, which is why active treatment, often surgical, is generally needed to achieve bone healing.

  • How is a nonunion fracture treated?

    Treatment typically involves surgery to stabilise the bone, sometimes with bone grafting to stimulate healing, and addressing any contributing factors such as infection or smoking that may have impaired initial healing.

  • When should I see an orthopaedic specialist about a suspected nonunion fracture, and how quickly can I be seen privately?

    See an orthopaedic specialist if a fracture hasn't healed within the expected timeframe with ongoing pain. A private orthopaedic surgeon can typically arrange assessment and imaging within about one to two weeks.