Supplemental Grafting as Adjunct to Other Operative Treatments
We are unable to recommend for or against the use of bone graft (autograft or allograft) or bone graft substitutes for the filling of a bone void as an adjunct to other operative treatments.

Rationale
We were interested in determining the role of bone void fillers in addition to operative fracture fixation. Only one study compared the use of allograft versus autograft after dorsal plating.61 No difference in pain or function was observed. They did however report complications related to autograft harvestation.

Several studies suggest some benefit related to pain reduction when calcium phosphate is used to support fixation.62-67 These studies did not compare the outcome of fixation with and without the material and hence are not applicable to this recommendation. We cannot support or discredit the use of bone substitutes as an adjunct to operative fixation.