Reconstruction after major loss of diaphyseal bone is a difficult problem with several possible solutions for the reconstructive surgeon : massive autologous graft, free bone flap and progressive migration of a bone segment . Since 1985 Masquelet et al developed a two stage procedure based on membrane induction that protects a massive cancellous bone autograft for reconstruction and enhances its corticalisation. Personally trained by the creator of this technique we found it especially interesting for gunshot injury of the lower limb, because of the lack of good recipient vessels for microsurgery . For all majors diaphyseal injury with massive bone loss after large debridement, the first step was to realize a large muscle flap to have an efficient coverage and to fill the gap with a methylmethacrylate cylinder that forms a pseudo synovial membrane. Six to ten weeks later the cement is removed and replaced by an autologous cancellous bone graft from the both posterior iliac crest. Between 1999 and 2004, 12 patients with gunshot of the lower limb (Gustillo 3 b) underwent this procedure 9 men and 3 women mean age 28 years. Bone loss measured 5cm to 15 cm and all the localization was tibia ; a soft tissue coverage by a free latissimus dorsi muscular flap with a skin graft was necessary in all cases. The mean follow up was one to 4 years, no failure of the flap occurred, one patient with a bone loss of 8 cm had a secondary fracture after complete weight bearing and was treated with a secondary bone graft in 11 cases the technique could be pursued to termination, radiological consolidation was achieved at 4.5 months . weight bearing without protection was authorized at a mean 9.5 month This series demonstrates that major bone loss reconstruction can be achieved using a traditional cancellous bone autograft. Prior induction of a pseudo synovial membrane using a surgical cement strut prevents graft resoption and enhances its vascularisation and corticalisation. The main indication for this technique is the leg since in the tibia the bone axis correspond to the mechanical axis.