Principles of bone grafting: non-union, delayed union

Autologous bone grafts or autografts (i.e. grafts taken from the patient's bone) have been used to treat fracture non-unions and occasionally to treat acute fractures. Traditionally, autologous bone is harvested from the iliac crest through a generous open incision. This can result in significant pain and morbidity. Nowadays, keyhole approaches to this site are often preferred. Alternatively, allografts (grafts from another person) or synthetic bone substitutes may be used. This contribution reviews the indications, contraindications and techniques of bone grafting, and briefly mentions new techniques of grafting and allografts and bone graft substitutes.