There was no displacement or paradoxical movement of the implant. Following surgery and at 18 month follow up the patient was asymptomatic with preserved quality of life and described no pain, localized tenderness or breathlessness. Histology confirmed clear all around microscopic margins. At surgery the implant was slotted into the defect and sutured to the ribs laterally and hemi-sternum medially. We designed the implant using an anatomical image of the ribs and right hemi-sternum and then fabricated a 3D model of them in titanium metal using TiMG 1 powder bed fusion technology. We estimated the extent of resection needed to ensure tumor-free margins by growing the tumor by two cm all around. To design the implant manual bone threshold segmentation was performed to create a 3-D virtual model of the patient’s chest and the tumor from sub-millimeter slice computed tomography (CT) scan data.

We describe the reconstruction of a large skeletal defect with a three-dimensional (3-D) printed custom-made, anatomically designed, titanium alloy ribs and hemi-sternum implant. Reconstructing this defect is complex and requires skeletal and soft tissue reconstruction.

Chest wall resection following wide local excision for bone tumor results in a large defect.