Minding the gap: management of bone defects after trauma

Bone defects which constitute a major orthopaedic challenge can arise from various causes, including trauma, infection, tumours, or surgical resections. These defects can lead to significant functional impairment and disability, particularly when they are classified as critical-sized defects. Treatment modalities for bone defects are influenced by factors such as defect size, the condition of adjacent soft tissue, and patient-specific considerations including age and co-morbidities. Therapeutic options include bone grafting techniques, distraction osteogenesis, and the Masquelet technique, each with its advantages and limitations. Recent advancements have improved surgical techniques and biomaterials, facilitating limb salvage and functional restoration. Emerging trends highlight the combination of treatment methods like the induced membrane technique and the use of titanium mesh cages, which enhance healing outcomes by providing stability and promoting vascular ingrowth. Innovative approaches in bone tissue engineering also offer promise in optimizing treatment for orthopaedic trauma patients with critical-sized defects. Future directions in research must focus on tailoring treatment options to individual patient needs while integrating advanced bone tissue engineering techniques to improve healing and restore functionality.