Regeneration of Periosteum in Denuded Bone

Fig. 1. Schematic of one-stage bone-transport procedure (yellow – bone, red – periosteum). A portion of diaphyseal bone is denuded of periosteum, osteotomized, and transported over an intramedullary nail to the site of the 2.54-cm critical-sized defect, where it is docked to the distal femur. The periosteal sheath is left in situ to surround the new defect site, leading to full infilling of the newly created defect with woven bone within 2 weeks after surgery and healing fully within 16 weeks post-surgery.