Use of solid and cancellous autologous bone graft for fractures and nonunions

Bone is the second most commonly implanted material in the human body, after blood transfusion, with an estimated 600,000 grafts performed annually. Although the market for bone graft substitutes is more than $1 billion, that of bone graft itself is still more than half that amount. Reports of autologous bone grafting date back to the ancient Egyptians, yet the modern scientific study of grafting began in the early 19th century. Since then, the indications, methodology, and science of bone grafts in nonunion and bone loss have been established and refined, and new methods of harvesting and treatment are being developed and implemented. This article describes the use of solid and cancellous bone graft in the treatment of acute bone loss and nonunion.