SummaryBone transport is a successful technique for the reconstruction of bone loss >4 cm. In the acute situation, principles of open-fracture management should be of highest priority. Conversion of a temporary four-pin monolateral external fixator to a one transport frame is carried out at the time of secondary débridement procedures. The use of free-flap coverage in concert with antibiotic cement beads is encouraged to maintain a well-vascularized transport corridor. Following corticotomy and bone transport, the flap is elevated, the antibiotic beads are removed, and can-cellous grafting of the docking site is performed. Grafting of the docking site decreases the incidence of nonunion as well as the overall treatment time. Solid union with minimal residual complications is achievable. Prolonged treatment time is the primary disadvantage of this technique, which requires strict patient compliance with pin care and patient adjustment of the external transport frame.