Revolutionizing Nonunion Treatment: The Expanding Role of Local Biological Therapies.

The diagnosis and treatment of long bone nonunion remains a historical challenge in the field of orthopedics. Bone nonunion management encompasses surgical and non-surgical options. This review discusses the potential use of untraditional methods in their treatment such as orthobiologics. The cornerstone of local biological therapies lies in their ability to directly stimulate the biological processes essential for bone repair. This precision targeting ensures that bone healing pathways are activated specifically where needed, enhancing both the rate and quality of union. It particularly addresses the use of biologic agents and the possibility of their combination with biomaterials to enhance their stability, delivery, and osteoconductive properties. The aim of this review is to obtain an updated point of view regarding the management of nonunion of the bone as well as expanding on the latest innovations aiming to create a shift from passive biologic supplementation to active regenerative engineering.