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Novel reconstruction of an open pilon fracture with significant bone loss. This is a case of how a polytrauma patient was managed successfully. This 47-year-old woman was a victim of a detonated improvised explosive device in a terror attack. She had multiple injuries and underwent damage control surgery. She suffered significant bone loss with an open distal tibia pilon fracture, which we reconstructed with novel techniques. About 18 months postoperative, she is mobilising without the use of any aids.