Void fillers in tibial plateau fractures

The treatment goals in metaphyseal defects are temporary mechanical support ofthe articular surface, healing or filling of the defect itself and restoration of bonestock to accommodate prosthesis placement. Cancellous defects not filled with abone substitute shows only limited new bone formation and the majority of thedefect remains open. Ideal bone graft material must have several following features:good osteointegration, osteoconduction, osteoinduction, osteogenesis, structuralintegrity, initial support to the articular surface, resorb at a rate similar to thesurrounding metaphyseal bone, preventing secondary subsidence, porous, easy touse, safe, cost-effective, similar strength to that of cortical/ cancellous bone.There is insufficient evidence about the best method, but autologous bone graft use, probablythe gold standard in young patients, is related to troublesome donor site pain. This supportsthe use of heterologous bone graft or bone cements. The standpoint that a single techniqueor material should be sufficient to cover all different bone defects, is outdated.