Background: Attempting limb reconstruction in the presence of critical bone loss usually involves surgery which had technically difficult, time-consuming, physically, and psychologically demanding for the case, with no guarantee of a satisfactory outcome. The function of the salvaged limb might be disappointing due to residual pain, joint stiffness, and neurovascular deficit. The case might require a secondary amputation due to refractory disease or non-union. Thus, the correct initial decision as to whether to embark upon limb reconstruction or to perform a primary amputation had important but difficult. Objective: The aim of this essay had to evaluate various treatment options for open femoral fracture with bone loss regarding, different methods to compensate for bone loss, and the complications of each one. Methods: PubMed, Google Scholar, and Science Direct were searched using the following keywords: Treatment of open femoral fracture, Bone loss, and Bone loss and complications. The authors also screened references from the relevant literature, including all the identified studies and reviews, only the most recent or complete study was included between June 2000 and December 2020. Documents in a language apart from English have been excluded as sources for interpretation were not found. Papers apart from main scientific studies had been excluded: documents unavailable as total written text, conversation, conference abstract papers, and dissertations. Conclusion: Bone loss had a relatively uncommon problem encountered in the treatment of open fractures, and usually occurs in the femur and tibia. The majority of defects had small and could be managed with standard methods of fixation, and autogenous bone grafting. Larger defects with complex soft-tissue problems could be managed by shortening, fixation with later lengthening.

Background: Osteonecrosis is a debilitating disease that may progress to collapse the subchondral bone and the articular cartilage of the joint.Objective: This study aimed to document the clinical and radiographic results of cementless total hip replacement (THA) in patients with osteonecrosis of the femoral head. Patients and Methods: This prospective clinical trial study was conducted on eighteen patients diagnosed with steroidinduced osteonecrosis of the femoral head at the Orthopedic Department, Zagazig University Hospitals during the period from August 2020 to the end of January 2021. All patients were subjected to Pre and post-operative clinical evaluation, special radiological assessment was applied. ResultsWe assessed the clinical signs and symptoms using a modified Harris hip score pre and post-operatively. MHHS of 90 points or more was categorized as an excellent result; 80-89 points were good; 70-79 points were fair; less than 70 points were poor results. Conclusion: Advancements in surgical technique and better designs have greatly improved the long-term survival of cementless implants in young patients with osteonecrosis of the femoral head.