ABSTRACT
Loss of a segment of the diaphysis of a long bone in children can occur following trauma, infection or after surgical resection of bone tumours. Rarer causes include resorption of bone in osteogenesis imperfecta and massive osteolysis. Instability at the site of the defect will preclude normal function of the limb. Shortening may be present if the problem has been longstanding and is frequently encountered in children with bone defects following infection in infancy. Deformity is often seen in limbs with defects secondary to infection and this would need to be corrected in addition to restoring continuity of the bone. Scarring and fibrosis of soft tissue around the bone defect occurs following infection and trauma or following radiotherapy to the area. This may preclude some forms of treatment; particularly those that entail vascular anastomosis. Autogenous non-vascularised bone graft is often effective in bridging diaphyseal defects in children and the fibula is frequently the chosen graft.
