Purpose: To assess the treatment results of long segmental bone defects using cylindrical titanium mesh cages.

Methods: A case series of six patients who sustained open Gustilo Anderson Type IIIB Tibia, Femur, and Humerus fractures, associated with extensive segmental bone and soft tissue loss. The patients were initially treated with serial wound irrigations, debridements, and external fixation. After the soft tissue envelope was successfully reconstructed by the Plastic Surgery Service, the large segmental bone defects were reconstructed with cylindrical titanium mesh cages packed with a composite of cancellous allograft and demineralized bone matrix putty, and stabilized with statically locked intra-medullary nails, or plates.

Results: The mean segmental bone loss was 9.2 cm (range: 7–13), and all patients had a minimum of one year follow-up. At one year post reconstruction, radiographs demonstrated stable, well aligned, and healed constructs, and computed tomography images confirmed the presence of bony in-growth through out the cages. All patients were able to full weight-bear ambulate, and all achieved good range of motion of the affected extremity, except for two patient that suffered drop foot, as a result of the index injury.

Conclusion: This technique appears to be a reasonable alternative in the treatment of large segmental bone defects of the Tibia.