A REVIEW OF CURRENT CONCEPTS IN THE MANAGEMENT OF BONE DEFECTS IN TRAUMA AND ORTHOPAEDICS.

Segmental bone defects represent one of the most demanding challenges in trauma and orthopaedic surgery. These defects commonly result from high-energy trauma, tumour resection, infection, or non-union, often compounded by soft tissue loss and systemic comorbidities. A broad range of reconstructive strategies is available, including autologous grafting, vascularized fibular grafts, allografts, distraction osteogenesis, and the Masquelet induced membrane technique. Treatment selection depends on defect size, host biology, and soft tissue condition, with classification systems such as Ferreira and Tanwar offering structured guidance. While traditional methods remain essential, recent advances are reshaping the reconstructive landscape. Biologics, synthetic bone substitutes, and 3D printing technologies are expanding the armamentarium, though their roles in routine care remain under evaluation. Despite these innovations, complications such as infection, prolonged treatment, and graft failure persist. This review synthesizes current concepts in bone defect management, including established and emerging techniques. It emphasizes that success depends not only on surgical method but also on host optimisation, early soft tissue reconstruction, and multidisciplinary collaboration. Future progress will require robust multicenter trials and incorporation of patient-reported outcomes to refine treatment algorithms and validate novel approaches.