Bone Transport Techniques—Classic (Ilizarov + Hexapod With Pins and Wires)

Bone transport using external fixation remains a vital limb salvage technique in the treatment of post-traumatic segmental bone loss and deformities. Classic circular external fixators based on the Ilizarov method have long been the gold standard for bone transport, offering multiplanar stability and the ability to regenerate bone across large defects. Progressive innovations with hexapod-based thin wire ring systems with computer assistance have allowed for increased precision, easier postoperative adjustability, and fewer reoperations. This review explores the fundamental principles of bone transport, compares classic Ilizarov and hexapod systems, and discusses technical considerations, advantages, and potential complications.