In the United States,more than 300,000 hip fractures occur annually in the elderly population with associated significant morbidity\nand mortality. Both intracapsular and extracapsular hip fractures have inherent treatment challenges and therefore are at risk\nof nonunion complications. A systematic assessment including radiographic, metabolic, and infectious evaluations should be\ncompleted for all patients suspected of nonunion. Failed internal fixation of intracapsular hip fractures is typically treated with\narthroplasty, while extracapsular proximal femur nonunions may be amenable to revision internal fixation or arthroplasty.While\nnot a classic hip fracture, bisphosphate associated subtrochanteric femur fractures affect a similar patient population and are\nhistorically difficult to treat. Atypical subtrochanteric femur fractures are at increased risk of nonunion given the altered biologic\nenvironment secondary to bisphosphonate use; therefore adjuvant therapies may be beneficial in setting of revision fixation.Having\na thorough understanding of nonunion risks, recognition, evaluation, and treatment is necessary for appropriate patient care.
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