Growing Bone: Lengthening and Grafting

Reconstruction of extremities with segmental loss requires simultaneous and ongoing care of the patient’s overall physiology, extremity vascular status, infection treatment or prevention, and soft tissue coverage. However, for the bone itself, options for filling bone defects include distraction techniques and various grafting options. Distraction osteogenesis by bone transport may be performed using external, internal, or a combination of fixation options. Bone grafting can be facilitated with application of the Masquelet technique in staged procedures. This chapter will review the pertinent technical points of both bone transport and Masquelet-induced membrane bone grafting and summarize the supporting literature for these techniques at each long bone site.