Aims: Surgical treatment big defect of long bone and soft tissue of extremities is one of more difþcult surgical problems in orthopedics and traumatology. Methods: A hundred and twenty patient with big defect of bone and soft tissue wounded during the war in Bosnia and Herzegovina ware treated in Cantons Hospital Zenica. Only twenty patient treated with primary shortening and secondary lengthening, with Illizarov technique and Ilizarov external þxation. Results: Defects of bone ware from 3 Ð 32 cm, the middling defect was 12 cm. The middling time of treatment by every patient was about one year. There were not any plastic operation, amputation, pseudarthrosis and osteomyelitis. Conclusions: Our experience said us that the primary shortening Ð secondary lengthening is the best of choice for treatment big defect of long bone and soft tissue of extremities.