1. IntroductionFracture healing is a dynamic process that can be interrupted by adverse factors at any stage, leading to delayed or incomplete repair. The incidence of impaired fracture healing reaches approximately 8–10% [1], while the nonunion rate for long bone fractures stands at about 5% [2]. When a fracture fails to heal within the anticipated timeframe, it is termed delayed union or nonunion. Although the definition of fracture nonunion remains under discussion, in China, the commonly accepted criteria define delayed union as failure to unite after 4 months, and nonunion as failure to unite after 8 months[3]. According to the FDA, fractures not healing within their expected period, typically 3–6 months, are considered delayed union, while a lack of healing over a 9 -month period with no radiographic progress for 3 consecutive months is labeled nonunion [4,5]. The International Orthopaedic Internal Fixation Association and the FDA both describe nonunion as the absence of healing within the expected clinical timeframe, with no signs of progress on imaging across a 3-month span. The patient in this report experienced delayed healing of a mid-femoral fracture after surgery, followed by a refracture, progressive bone resorption, and nonunion. Treating such cases poses significant challenges, and the likelihood of recovery is limited. However, after receiving platelet-rich plasma therapy in conjunction with shockwave treatment and structured rehabilitation, the patient showed a favorable outcome. This case serves as a basis for sharing the diagnostic and therapeutic approach we adopted, in the hope that it offers practical value in managing similar cases.