Objective To analyze the clinical characteristics of bone defects in various cases for the individualized design and treatment of bone transplantation. Methods From January, 2009 to December, 2014, 27 cases of bone defect cases were treated. Each case was detailed condition assessment, according to age, defect shape, defect region on the body and so on a variety of factors, formulate detailed and reasonable treatment scheme, using single fibula, folded fibula, fibula tripodism and iliac bone morphology rules, combined with bone and soft tissue flap, in order to achieve the final best effect. Results A group of 27 cases of bone transplantation, including patients with chronic osteomyelitis, in accordance with the normal fracture healing time to healing in the 13 iliac bone, 12 fibulae, 1 tibias bone and 1 navicular bone replantation, followed up 6 months to 5 years without delay and nonunion occurred. Two years later, the 1 child case femoral shaft diameter close to normal femur. Two cases triangular supporting bone graft after 2 years by thick, triangular central formate to a circular hole. The E type deformity of the Pilon fracture was not only disappear in this case after the operation, but also walking freely. One case of lateral ankle reconstruction was without pain, no abnormal function. Seven cases with hand bone transplantation had no delayed union and hand function evaluation: 80%. One case with fibular flap blood supply problem, part of dermal ulceration, healed after change dressings. Conclusion Under the premise in master microsurgical technique and rich clinical experience, based on the purpose of the final best effect, each case different situations of patients with bone defects by a personalized microsurgical free bone transplantation in the treatment can greatly shorten the course of treatment, improve treatment effect and patient satisfaction. It is worth attention and promotion. Key words: Bone defect; Bone transplantation; Indiridualized desigh; Microsurgical technigue