Bone plates for the fixation of complex fractures in proximity to joints often have to be reshaped to follow the bone contour. Good adhesion of the screws in areas where the bone is osteoporotic is also a challenge. One possible solution to these issues is to tailor-make plates by creating a digital three-dimensional model of the fracture from a computed tomography (CT) scan, digitally reducing the fracture, designing a plate, and finally manufacturing it directly from the digital model with so lid free-form fabrication (SFF) technology. This study designs a custom plate for a distal tibia fracture, and investigates and refines the procedure from the CT scan to the final implant, with the aim of making it usable in trauma orthopaedics. The bone plate is manufactured using electro n beam melting (EBM) technology. The challenges of bone plate design using digitalization and SFF are discussed. The virtual models created by the engineer while digitally reducing the fracture and modeling the plate arc valuable fur the physician while planning the surgery. A combination of surgery planning and digital plate design improve s the surgeon's preparations and ensures correspondence between the plan and the designed implant. The proposed procedure, with the approximate required time in brackets, includes the separation of bone in the DICOM tile (60 min), the reduction of fracture (5-30 min), revision (30 min), modeling of the plate (30-120 min), confirmation (30 min), manufacturing with SFF (10 h), post-processing (60 min), and finally cleaning and sterilization (90 min). The whole procedure requires about three working days.