Bone graft options
Autogenous cancellous bone graft, harvested from any standard donor site is the material of choice for promoting union and filling smaller defects.
For treating tibial fractures, posterolateral, or central placement, adjacent to healthy muscle, may avoid the infected focus. For the humerus, femur, or forearm, the best position of the graft depends on the defect, the soft-tissue envelope and the fixation.
Bone defects remaining after resection of dead, or infected, bone are challenging to treat. The longer the defect, the more difficult the treatment.
Circumferential defects of 1-6 cm in long bones usually heal if filled with autogenous bone graft, and stabilized appropriately. Defects greater than this usually need distraction osteogenesis, or free vascularized bone transfer.