Bone grafts,bone substitutes and orthobiologics: The bridge between basic science and clinical advancements in fracture healing

The biology of fracture healing is better understood than ever before, with advancements such as the locking screw leading to more predictable and less eventful osseous healing. However, at times one’s intrinsic biological response, and even concurrent surgical stabilization, is inadequate. In hopes of facilitating osseous union, bone grafts, bone substitutes and orthobiologics are being relied on more than ever before. The osteoinductive, osteoconductive and osteogenic properties of these substrates have been elucidated in the basic science literature and validated in clinical orthopaedic practice. Furthermore, an industry built around these items is more successful and in demand than ever before. This review provides a comprehensive overview of the basic science, clinical utility and economics of bone grafts, bone substitutes and orthobiologics.     

Trauma among early Californians

The incidence and distribution of trauma is examined in a large number of individuals from many burial sites in California. The material represents part of an on-going curational effort at the Lowie Museum of Anthropology. Trauma is confined to fractures, dislocations, and projectile wounds for the purposes of this study. Only antemortem fractures are considered. The findings suggest that most fracture were due to accidents, though several parry fractures are present. The functional results of healing do not warrant any conclusions as to the efficacy of treatment or lack thereof. Several projectile wounds are seen, some with evidence of healing. Presented in part at the 55th annual meeting of the American Association of Physical Anthropologists, Albuquerque, New Mexico, April 1986.