OBJECTIVES::
Treatment of segmental long bone defects is one of the areas of substantial controversy in current orthopaedic trauma. The main purpose of this survey was to determine current practice and practice variation within the OTA membership on this topic.

DESIGN::
Survey.

SETTING::
Web-based survey.

PARTICIPANTS::
379 orthopaedic trauma surgeons.

METHODS::
A 15 item questionnaire-based study titled "OTA Open Fracture Survey" was constructed. The survey was delivered to all OTA membership categories. Different components of the data charts were used to analyze various aspects of open fracture management, focusing on definitive treatment and materials used for grafting in "critical-sized" segmental bone defects.

RESULTS::
Between July and August 2012 a total of 379/1545 members responded for a 25% response rate. Overall, 89.5% (339/379) of respondents use some sort of antibiotic cement spacer prior to bone grafting. It was found that 92% of respondents preferred to use some type of autograft at time of definitive grafting of segmental defects. When utilizing a grafting technique, 88% said they used some type of antibiotic cement. Within that context, 60.1% said graft placement should be done at 6 weeks.

CONCLUSIONS::
There continues to be substantial variation in the timing of bone graft placement after soft tissue healing as well as the source and form of graft utilized. The use of antibiotic cement is common in segmental defects that require delayed bone grafting. Obtaining base-line practice characteristics on controversial topics will help provide a foundation for assessing research needs and, therefore, goals.

LEVEL OF EVIDENCE::
Therapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.