Bone transport, along with allied techniques of compression distraction, offer exciting new treatment alternatives for the difficult problem of segmental bone loss from acute trauma. Many factors must be considered before indicating these treatment methods, because it is clear that many of the problems that existed with more conventional methods also exist with these techniques. The indications for amputation vs. limb salvage must always be considered in these severe injuries. In less severe injuries with minimal bone loss and soft-tissue injury exposing well-vascularized segments of bone, traditional methods of stabilization, soft-tissue coverage, and grafting lead to more rapid healing times and return to function for patients. These techniques are reserved for the most severe type of injuries for which treatment times are long and complications not infrequent. Therefore, methods to speed treatment, avoid complications, and increase patient acceptance should be actively sought. The great advantage of these techniques is that the vast majority of the reconstruction is done on the injured limb segment, with minimal need for extensive donor-site defects.