Limb Salvage After Massive Traumatic Femoral Bone Loss

The initial decision of whether to pursue limb salvage or primary amputation depends on the state of nerves, vessels, and soft tissue. The treatment protocol in damage control consists of debridement and irrigation, vascular repair, fracture repair, and temporary skin coverage. Associated massive bone loss remains a challenge for the treating surgeon. The Ilizarov method of distraction osteogenesis with bone transport has successfully treated large segmental bone defects. However, treatment is usually long and adverse events are not uncommon. There are technical pearls that may diminish these problems and they are revealed in this case.