[Reconstruction of dia- and metaphyseal post-traumatic cortical bone defects]

Forty-one of 55 defect pseudarthroses, most of them with infections, were cured to healing in five years. Autogenic spongiosa proved to be best suitable for soft-tissue repair in cases of non-segmental defects, whereas structured corticalis worked better as a transplant for somewhat stretched and longish segmental defects. Compact osteomyocutaneous free tissue transfer was found to be accompanied by high rates of complications. The tactics of small steps seems to be more promising than anything else for both spongiosa transplantation and corticalis transfer. Fibula-pro-tibia transposition, comparable to the short-distance flap technique, as well as distractive corticotomy should be applied more often, especially to younger patients.