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Chest wall resection following wide local excision for bone tumor results in a large defect. Reconstructing this defect is complex and requires skeletal and soft tissue reconstruction. 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. 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 tomogr