Use of Osteobiologics for Fracture Management: The When, What, and How

•Osteobiologics are a group of synthetic and naturally derived substances used to support the bone repair. While most bones heal uneventfully with suitable operative or non-operative treatment, bone healing may be complicated by a loss of alignment, delayed union, or nonunion. The appropriate use of osteobiologics may stimulate healing and mitigate these complications. In this review, we evaluate when to use osteobiologics, what osteobiologics are currently available, and how to best employ them. Osteobiologics are defined as a group of natural and synthetic materials used to augment bone healing. The selection of the most appropriate osteobiologic from the growing list of available options can be a challenging task. In selecting a material, surgeons should weigh a variety of considerations, including the indication for their use (the when), the most suitable substance (the what), and the correct mode of application (the how). This summary reviews these considerations and seeks to provide the surgeon with a basis for informed clinical evidence-based decision-making in their choice of a successful option.