[Reconstruction of post-traumatic diaphyseal bone loss by segmental bone transfer]

Until the beginning of the 1980s, reconstruction of major post-traumatic diaphyseal bone loss as an alternative to amputation was possible only by massive autologous bone grafts. Such a technique was limited by the amount of available bone required for grafting. Ilizarov explained the distraction osteogenesis principle and designed a circular external fixation material that was suitable for compression-extension. He described the concept of segmental bone transfer, which allows bone regeneration to take place within the actual injured limb. Our present experience is based on the literature and the study of 12 cases. All patients presented with significant post-traumatic tibial bone loss ranging from 45 to 145 mm. In this article, we discuss the indications, benefits and risks of such a technique compared to classic methods. Mainly indicated in patients who have sustained significant bone loss, bone transfer is the method of choice for preserving bone stock and correcting limb discrepancy, although it does not reduce consolidation time. Moreover, circular external fixations are often poorly tolerated and may be replaced by unilateral devices that are easier to install.