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Background: Internal fixation for severe open articular bone defects is sometimes ineffective or dangerous. In the emergency stage, radical debridement and infection prevention are demanded to provide a good tissue base and the space‐occupying effect to provide enough necessary space to avoid soft‐tissue contraction for the reconstruction. In addition, the 3D printing technology makes individual limb reconstruction a reality. Case Presentation: Here, we present a 31‐year‐old patient with an open fracture and severe bone defect of his left elbow caused by traffic accident, classified as Gustilo–Anderson IIIB. We adopted aggressive debridement and insertion of polymethyl methacrylate (PMMA) to prevent the infection and temporarily construct the bone defect in the emergency stage. Secondly, the total elbow arthroplasty was performed using a unique three‐dimensional (3D) printed prosthesis to reconstruct the elbow joint. During the follow‐up, the elbow movement function was satisfactory. Conclusions: The modified Masquelet technique assisting 3D printing of personalized elbow joint makes the satisfactory functional reconstruction for open high‐energy injuries come true. It could be promoted for the similar surgery of other open joints fractures with severe bone defects. [ABSTRACT FROM AUTHOR]