The development of effective bone graft substitutes is one of the most important innovations in musculoskeletal surgery. Bone graft substitutes provide an osteoconductive scaffolding similar to those of autogenous bone. They eliminate donor site morbidity,decrease operative time and complexity and treatment costs, and improve patient satisfaction. Osteoinductive and osteogenic elements may be added to further stimulate and enhance healing and incorporation of the scaffolding substance into the adjacent bone. Bone graft substitutes have proven effective in the spine and larger long bones of the extremities. The continuing development of bone graft substitutes, evaluation of their efficacy relative to autogenous bone grafts and to each other, and their use in the hand and wrist are emerging fields.
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