The bridging of large bone defects in compound wounds is practicable, and has for its basis the monumental experimental work of contributors for the past several centuries, as well as the large clinical applications and contributions during the past two or three decades. Massive autogenous bone grafts, perfectly fitted to the host and held by adequate internal and external fixation, confirm our present and past theories of osteogenesis, and behave according to the laws of Roux and Wolff. One stumbling block has been mechanical fixation, and this has been circumvented by the massive graft with internal and external fixation. The elimination of infection through the systemic use of sulfonamides and the local and systemic use of penicillin, the replacement of skin and scar defects, and the restoration of the normal physiology, all of which might be considered as converting the compound fracture into a simple fracture, seem to have a brilliant future in the handling of this most difficult of all fracture complications.