Introduction <p>Junctional regions of the lower-extremity long bones (proximal femur, distal femur, distal tibia, and proximal tibia) pose unique challenges due to their complex anatomy and biomechanics, often leading to delayed union or nonunion.</p> Objective <p>We review contemporary strategies for stabilizing fractures at anatomical junctions, focusing on implant configurations and augmentation methods.</p> Methods <p>The review integrates outcome data from Indian and global cohorts, critiques pragmatic solutions used in clinical practice, and discusses emerging trends such as bespoke additive-manufactured implants, next-generation orthobiologic options, and artificial-intelligence-enabled preoperative planning.</p> Results <p>The key findings include the critical role of mechanical stability (with techniques like dual plating or nail-plate combinations) in preventing delayed union/nonunion, and the integration of biological approaches such as the “diamond concept” to optimize healing. Early mechanical augmentation in high-risk fractures (e.g., medial or dual plating in periarticular regions) has shown improved union rates and faster healing. In significant bone defects, strategies like autografts, induced membranes, and antibiotic-laden bone substitutes have further addressed the compromised healing environment common to these injuries.</p> Conclusion <p>Though initially may appear to be “an Overkill”, integrative approaches combining mechanical and biological optimization now form the cornerstone of effective treatment of these junctional fractures. The paradigm shift toward early robust fixation with adjunctive biological enhancement has significantly improved union rates and functional outcomes in these challenging junctional delayed union/nonunion.</p>