Bone Graft Substitutes in the Treatment of Distal Radius and Upper Limb Injuries

Over the years, autologous and allogeneic bone grafts have been used to supplement techniques in internal and external fixation to treat fractures in the upper extremity. The development of a variety of bone graft substitutes has allowed the use of these materials when there are significant comorbidities in harvesting autograft or when the use of allograft is undesirable. With recent advances in the synthesis, testing, and employment of bone graft substitutes, these materials have been used in the treatment of upper extremity fractures to fill a bony defect, to correct skeletal deformity. to restore structural integrity, and to stimulate bone healing. In this chapter, we will identify the major types of graft substitutes available or in development and review their unique features and capabilities. The authors have no financial interest in any of these products; rather, the cases included in this review are included solely as examples of the various types of commercially available products. The indications and potential applications for graft substitutes in the distal radius and the upper limb will be discussed, as we contemplate the future direction in the research and development of new graft substitutes. (C) 2009 Elsevier Inc. All rights reserved.