High-velocity injuries mostly due to road traffic accidents may result in post-traumatic bone loss. Such mutilating injuries of the extremities need careful assessment, thorough evaluation and early management. Extrusion of a diaphyseal fragment of a long bone of the extremity has been a challenge for the treating surgeon (Fig. 9.1a–e). The commonly suggested procedures to bridge such a bone loss are autologous fibular grafts—both non-vascularized and vascularized—bone transport, the Ilizarov technique and allografts.