{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T23:30:19Z","timestamp":1793230219395,"version":"4.5.0"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>We report a case involving a 21-year-old woman who sustained a Grade III open pilon fracture of the left ankle during a motor vehicle accident that resulted in a 12-cm critical-sized bone defect (CSD) that was successfully treated with a three-dimensional (3D) printed titanium alloy (Ti-6Al-4V) cage, a tibiotalocalcaneal intramedullary nail, and autogenous and allograft bone. The patient\u2019s reported outcome measures were comparable with those reported for non-CSD injuries at 3-year follow-up. The authors conclude that 3D printed titanium cages offers a unique approach to traumatic limb salvage for tibial CSD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>3D printing offers a novel solution to CSDs. To the best of our knowledge, this case report details the largest 3D printed cage, to date, used to treat tibial bone loss. This report describes a unique approach to traumatic limb salvage with favorable patient-reported outcomes and evidence of radiographic fusion at a 3-year follow up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.22.00077","type":"journal-article","created":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T14:00:39Z","timestamp":1677074439000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Three-Year Follow-Up of a Traumatic Critical-Sized Tibial Bone Defect Treated with a 3D Printed Titanium Cage"],"prefix":"10.2106","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8810-3319","authenticated-orcid":false,"given":"Lindsey G.","family":"Johnson","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina"},{"name":"Campbell University School of Osteopathic Medicine, Lillington, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6393-1983","authenticated-orcid":false,"given":"Molly M.","family":"Kearney","sequence":"additional","affiliation":[{"name":"Campbell University School of Osteopathic Medicine, Lillington, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4866-125X","authenticated-orcid":false,"given":"Nicholas B.","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel B.","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,1]]},"reference":[{"issue":"4","key":"bib1-20240805","first-page":"e20.00230","article-title":"Three-dimensional printing in orthopaedic surgery: current applications and future developments","volume":"5","author":"Wixted","year":"2021","journal-title":"J Am Acad Orthop Surg Glob Res Rev."},{"issue":"5","key":"bib2-20240805","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1177\/1071100716688176","article-title":"Predictors of patient-reported function and pain outcomes in operative ankle fractures","volume":"38","author":"Dean","year":"2017","journal-title":"Foot Ankle Int."},{"issue":"1","key":"bib3-20240805","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s41687-020-00203-y","article-title":"Pattern of recovery and outcomes of patient reported physical function and pain interference after ankle fusion: a retrospective cohort study","volume":"4","author":"Kohring","year":"2020","journal-title":"J Patient Rep Outcomes."},{"issue":"4","key":"bib4-20240805","doi-asserted-by":"crossref","first-page":"e043","DOI":"10.1097\/OI9.0000000000000043","article-title":"Long-term outcomes after operative treatment for tibial pilon fractures","volume":"2","author":"van der Vliet","year":"2019","journal-title":"OTA Int."},{"issue":"4","key":"bib5-20240805","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1177\/1071100715620895","article-title":"Salvage of severe foot and ankle trauma with a 3D printed scaffold","volume":"37","author":"Hamid","year":"2016","journal-title":"Foot Ankle Int."},{"key":"bib6-20240805","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2019\/7571013","article-title":"Five-year follow-up of distal tibia bone and foot and ankle trauma treated with a 3D-printed titanium cage","volume":"2019","author":"Nwankwo","year":"2019","journal-title":"Case Rep Orthop."},{"issue":"9","key":"bib7-20240805","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1177\/10711007211002807","article-title":"Talonavicular joint-sparing 3D printed navicular replacement for osteonecrosis of the navicular","volume":"42","author":"Adams","year":"2021","journal-title":"Foot Ankle Int."},{"issue":"8","key":"bib8-20240805","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1177\/1071100718770133","article-title":"Use of patient-specific 3D-printed titanium implants for complex foot and ankle limb salvage, deformity correction, and arthrodesis procedures","volume":"39","author":"Dekker","year":"2018","journal-title":"Foot Ankle Int."},{"issue":"1","key":"bib9-20240805","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s41205-020-00083-4","article-title":"Clinical applications of custom 3D printed implants in complex lower extremity reconstruction","volume":"6","author":"Kadakia","year":"2020","journal-title":"3D Print Med."},{"issue":"6","key":"bib10-20240805","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1053\/j.jfas.2019.10.015","article-title":"Comparison of 3D printed spherical implants versus femoral head allografts for tibiotalocalcaneal arthrodesis","volume":"59","author":"Steele","year":"2020","journal-title":"J Foot Ankle Surg."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.22.00077","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:42:04Z","timestamp":1787751724000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.22.00077"}},"subtitle":["A Case 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