Challenging non-union of the long bones is a difficult to manage and usually results in failures. After repeated implant failures, non-unions become resistant to treatment. In most of such cases, the bone is often osteoporotic, with a large bone gap between the bone segments, and union is usually difficult to achieve (Fig. 12.1). The selection of a viable technique for the treatment of osteoporotic bones has been a problem for the treating surgeon. As a result of repeated attempts of fixation using metallic nails or plates, the osteogenic capacity of the already osteoporotic bone is further compromised.