This biological nail can also be inserted into long bones with a benign lesion of the shaft, which may otherwise result in a pathological fracture (Fig. 13.1a–d). A fibular strut can also be inserted into any fragile long bone with severe osteoporosis and diaphyseal lesions threatening a fracture (Fig. 13.2a–d). The insertion of a free autologous intramedullary fibular strut graft provided mechanical stability, and osteogenesis occurred inside the medullary canal of the host bone.