Repair of segmental bone defects is an enormous challenge for foot and ankle surgeons. This report describes the case of an unusual technique for managing segmental bone voids about the ankle, namely the use of a cylindrical titanium cage packed with bone graft, and an intramedullary nail. The technique was successful at bridging a large segmental defect, and biopsy specimens procured from the length of the healed graft confirmed osseous consolidation.
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