3A.47 Large proximal or distal defect, with or without loss of length. (a) Large distal defect in the femur; LRS ADVanced (53000 series) in place. Proximal metaphyseal osteotomy. (b) Middle segment moved distally until docking occurs. (c) Optional additional lengthening proximally, if indicated. Use of HA-coated screws is recommended.

3A.48 Large central bony defect. (a) LRS ADVanced (53000 series) in place. (b) Proximal and distal metaphyseal osteotomies performed. (c) Simultaneous proximal and distal transport until segments meet. Use of HA-coated screws is recommended.

3A.49 Large peripheral bony defect. (a) LRS ADVanced (53000 series) in place. (b) Two osteotomies performed in the longer bone segment. (c) Simultaneous proximal transport with both middle clamps moved proximally until gap closed. Use of HA-coated screws is recommended.

3A.50 (a) Small distal defect in the femur. LRS ADVanced (53000 series) in place. (b) Immediate compression between middle and distal clamps; proximal osteotomy. (c) Lengthening at proximal osteotomy site until length restored. Use of HA-coated screws is recommended.