Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 9 1 2023 06 16 1 5 Osama Farouk Department of Orthopedics, Assiut University Hospital, Assiut, Egypt Ahmed Khalifa Department of Orthopaedic, Qena Faculty Of Medicine, South Valley University, Qena, Egypt & Assiut University Hospital, Assiut, Egypt 2022 03 22 2022 05 14 Segmental tibial bone defects (STBD) represent a dilemma for the trauma surgeon; these defects could result from trauma, after debridement for infection, or after tumor resection. We aimed in this review to shed some light on the various reconstruction options without the need to use a circular fixator. Reconstruction options rely on various factors related to the patient, the surgeon, and the nature of the defect (location and size). Various reconstruction techniques include simple bone grafting (autograft or allografts), bone transport [distraction osteogenesis (DO)], induced membrane technique, and vascularized fibular graft. Fixation could be performed using either internal or external fixators; the latter could be a circular or a unilateral frame. Although circular frames (Ilizarov) fixators reported good results, they are still considered cumbersome, need special attention, carry pin tract infection risk, and could not be tolerated by patients. Hence, various other options were introduced, such as bone transport over an intramedullary nail (IMN), rail monolateral external fixator, and tibialisation of the ipsilateral fibula. https://jost.tums.ac.ir/index.php/jost/article/view/381 https://jost.tums.ac.ir/index.php/jost/article/download/381/295