Bone Transport with Internal Devices

Bone defects on a traumatic, infectious or malignant background are effectively treated by distraction osteogenesis with internal bone transport nails, improving patient comfort, reducing treatment time, and minimizing complications during a treatment course that has traditionally been long and burdensome. This article describes a patient selection, indications, devices, techniques, complications, and our suggested treatment protocol. The nails allow for combinations of transport and lengthening, avoiding the use of external fixators and their inherent drawbacks: pin track infection, scarring, and the inconvenience of carrying an external device for a prolonged time. Modern implants allow full weight-bearing during treatment. Meticulous surgical planning, infection prophylaxis, healthy soft tissues, vigorous training, and rehabilitation are essential for good outcomes.