[Defect fractures of the tibia--various forms of bone replacement].

Different bone substitutes exist for reconstruction of segmental tibial bone defects. The choice of bone substitute is limited by the quality of the surrounding tissue and the size of the bone defect. Especially in large bone defects, the freely or microvascularly transferred autogenic graft should be preferred. Allogenic transplants or artificial bone substitutes, such as spongy calcium phosphate materials, are suitable only for implantation in smaller, well-vascularized bone defects or as an additional procedure in large bone defects. In infected cases, allogenic and artificial, especially slowly resorbable implants, have to be avoided. The prerequisite for defect reconstruction is stable internal fixation.