Large bone void in a tibial plateau fracture?
Fracture repair at IU Health, IN: what to ask before you fill that void.
You are fixing a tibial plateau fracture. After the joint surface is lifted back up, the hole left behind is too big to leave empty. You need to fill it so the plateau does not sink under weight. At IU Health, surgeons see this after high-energy falls and car crashes. The question is which graft will hold up under that load.
When the top of the shin bone breaks, the joint surface often gets pushed down. The surgeon raises it back into place. That leaves a hollow space in the bone underneath. If you do not fill that space, the surface can settle back down and the knee loses its shape. This is the large bone void you are dealing with. It is common after a high-energy tibial plateau fracture, and it must be handled during the fracture repair.
Filling the void happens during the same surgery, so there is no separate operation. The added graft cost depends on the size of the hole and the product your surgeon chooses. A moldable, high-porosity graft like ALTAPORE SHAPE packs into irregular voids and stays put. For smaller gaps just under the joint surface, a flowable graft fills every corner without leaving dead space. No graft is load-bearing by itself. It must always be paired with plates and screws that hold the bone still.
This week, talk with your surgeon at IU Health about exactly how the void will be filled. Ask if the graft resists compression and supports the joint surface. Ask whether a moldable or flowable option fits your defect size and shape. Request the evidence behind the product, not just a name. Elite Surgical can bring that published data to your operating room and walk your team through handling the graft during your fracture repair.
Once the void is filled and the fixation is stable, the joint surface has something solid under it. New bone grows across the graft instead of into an empty gap. You can start knee movement without worrying the plateau will collapse. The bone heals in a position that keeps the joint line even.
Other things people in IU Health ask
weight bearing after tibial plateau fracture with synthetic bone graft
Weight bearing depends on the fixation, not the graft. The graft provides a scaffold for bone ingrowth but does not add immediate structural support. Follow your standard postoperative protocol for the plate and screws. Most patients stay non-weight-bearing for 8 to 12 weeks, with progression based on X-ray healing. The graft will remodel over that time; early loading does not speed it up.
how to choose bone graft substitute for distal radius fracture
Match the graft form to the void shape. For a small, contained cavity, a flowable graft in a syringe (like ACTIFUSE FLOW) fills every corner without overpacking. For a larger, uncontained defect, a moldable graft (like ACTIFUSE SHAPE) holds its form and does not migrate. If you need antibiotic delivery, ACTIFUSE ABX gives you enhanced handling plus the option to mix in powdered antibiotics. Avoid granules that can scatter into the joint.
cost of bone graft substitute for calcaneus fracture
Calcaneus fractures often need 5cc to 10cc of graft. Price it by volume, not by level. Synthetic grafts like ACTIFUSE are priced per cc. Ask your rep for a per-case cost breakdown that includes the delivery system. Compare that to the cost of a second surgery if the void is left unfilled or collapses.
synthetic bone graft safe open fracture
Synthetic grafts like ACTIFUSE are inorganic and do not provide a food source for bacteria the way allograft can. They can be used in a contaminated field after thorough debridement and irrigation. Many surgeons place the graft at the index procedure to maintain space and deliver local antibiotics mixed into the graft. If there is gross purulence, stage the grafting for a second look 48 to 72 hours later.
ACTIFUSE FLOW vs ACTIFUSE SHAPE fracture
For narrow, deep voids where you need the graft to flow into crevices, use ACTIFUSE FLOW. Its syringe delivery lets you place it precisely without overpacking. For a wide, shallow defect that needs to hold its shape while you close, ACTIFUSE SHAPE molds to the cavity and stays in place. If the void is both deep and wide, start with FLOW to fill the bottom, then cap it with SHAPE.
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Elite Surgical handles fracture repair in IU Health and the area around it.