Bone Defect Nonunion of the Lower Extremity

Summary When bone loss is the cause of nonunion, treatment options are contingent on several factors including the extent of the bone defect, the vascularity and integrity of surrounding soft tissue, as well as the location of the defect. Amputation may be preferable to a prolonged series of reconstructive surgeries with ultimate significant compromise to function. Surgical reconstruction may entail managing overlying soft tissue defects, dead space management, bone grafting, vascularized bone or osteocutaneous transfer, or distraction osteogenesis. Treatment should be individualized based on the nature of the defect, the patient’s functional expectations and needs, as well as the surgeon’s experience and expertise.