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The treatment of large diaphyseal defects has remained in the domain of autologous bone transplantation, but has been substantially complemented by the Ilazarow technique. Bone formation following transplantation or segmental transport is controlled by three interacting mechanisms involving osteoregeneration, osteovascularization and osteostabilization. All three components are equally important in the healing process of large cortical defects. Osteoregeneration is inseparably linked to an intact bone matrix. Therefore, entirely inorganic bone substitutes are not suitable for difficult conditions such as is the case diaphyseal defects.
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