Objective To review the results of bone transport using a unilateral external fixator plus autografts for treatment of posttraumatic chronic osteomyelitis of lower limbs.Methods A retrospective analysis was made of 18 patients sustaining posttraumatic chronic osteomyelitis following femoral or tibiofibular fracture between September 2008 and September 2014.After bone transport with a unilateral external fixator in all,9 had autologous ilium bone grafting and plate osteosynthesis.Ossification of new bone was assessed by bone healing index(BHI).Outcome was assessed by Paley score.Results At the follow-up of 10-24 months (mean,13.5 months),union was achieved and infection was eradicated in all patients.Period of bone union was (46.3 ± 10.3)weeks in all,but a relatively much shorter period of time [(41.4 ± 10.4)weeks] was observed in patients with autologous bone grafting.Duration from bone transport to removal of external fixator was (42.9 ± 13.0) weeks in all,and was (34.7 ± 11.8) weeks in patients with autologous bone grafting.BHI was (1.9 ± 0.6) m / cm in all,and was (1.4 ± 0.4) m/cm in patients with autologous bone grafting.According to the Paley score,bone results were excellent in 15 patients and good in 3 patients,and functional results were excellent in 9 patients,good in 6 patients and fair in 3 patients.Pin-tract infection occurred in 5 patients,bone infection in 3,delayed union in 2,stiff joints in 3,and pin adjustment in 5 (including 3 malunions).Conclusions Bone transport using a unilateral external fixator is an effective treatment procedure for posttraumatic chronic osteomyelitis.After bone transport,autologous ilium bone grafting and plate osteosynthesis is a feasible method to shorten the external fixation time and total hospital length of stay.