Femoral truss cage

Case contributed by Nicola Zelow


Multi trauma MVA. Comminuted fracture of the distal third of the right femoral shaft.

Patient Data

Gender: Male

There is a soft tissue injury to the lateral aspect of the lower thigh with an underlying comminuted fracture of the junction of the middle and distal thirds of the shaft of the femur.


The single AP view of the femur demonstrates an osteotomy through the distal shaft of the site of the previous fracture, with distally locked intramedullary nail spanning the 10cm bone defect. The defect is filled with antibiotic beads. 


Intra-operative insertion of TRUSS and femoral nail

The antibiotic beads have been removed, with the newly inserted truss implant spanning the length of the bone defect.

Distally locked intramedullary nail in place.


Compared with previous radiographic examinations, there is no change in the position of the femoral nail nor of the femoral screws and truss.

ACL reconstruction and medial collateral ligament repair of the left knee noted.

Case Discussion

The truss cage is a 3D printed patient-specific titanium alloy implant 1. Prior to the insertion of the truss, the patient underwent a planning CT scan whereby the DICOM images were used to create an implant that is customized to the patient's anatomy.

Truss configurations are well known in engineering as they provide high strength with low weight2. The open architecture of the truss implant allows for maximum bone graft material to be incorporated within the cage itself, while the nature of the truss design stimulates bone growth and remodeling1

Disclosure - I, Nicola Zelow, have no actual or potential ethical or financial conflict of interest in relation to this device. This case is not intended to be a personal endorsement or recommendation of this product.

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Case information

rID: 54230
Published: 21st Sep 2017
Last edited: 26th Apr 2020
Inclusion in quiz mode: Included

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