Novel Use of Axial Cage With Nonvascularized Fibula Autograft for Ankle Arthrodesis After Bone Loss: A Case Report.

CASE: A 56-year-old morbidly obese woman sustained a high energy motor vehicle collision resulting in an isolated Gustilo-Anderson type IIIA open pilon fracture of the right ankle, with massive distal tibial bone loss. Limb salvage was achieved through the novel use of an off-the-shelf axial titanium spine cage combined with a nonvascularized fibula autograft and hindfoot intramedullary nail arthrodesis.

CONCLUSION: This technique may offer a practical and durable alternative for limb salvage in cases of massive distal tibial bone loss, particularly in resource-constrained settings when access to custom 3D-printed implants or microvascular reconstruction is limited.