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INTRODUCCIÓN Los elementos estándares de osteosíntesis están desarrollados pensando en Fractura. No en pérdida de substancia ósea.La mayoría de los trabajos publicados al respecto de los defectos segmentarios son Case Reports... hace falta un estudio sistemático, y la generación de un sistema de clasificación prácticco, orientado a la toma de decisiones acerca de la mejor reconstrucción. Trauma,osteomyelitis, bone tumour resections or treatment of congenital deformitiesare main causes of bone deficiency. Their treatment has been thoroughlystudied for the last 35 years and both vascularized bone graftingand distraction osteogenesis with the Ilizarov technique have emerged as

gold standards.Generally, after trauma, the majority of defects are less than 4 cmand can be managed using standard methods of fixation withautogenous bone grafting.11 However, large segmental bonedefects, especially in the setting of an unfavourable woundenvironment, previously sub-optimal surgical technique orbiomechanical instability are usually characterized by lowregeneration potential and will require more specialized surgicalmanagement.(Lasanianos, N. G., Kanakaris, N. K., & Giannoudis, P. V. (2009). Current management of long bone large segmental defects. Orthopaedics and Trauma, 24(2), 149–163. http://doi.org/10.1016/j.mporth.2009.10.003)

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