High-energy tibial pilon fractures frequently lead to complex intra-articular injuries, metaphyseal bone loss, and articular surface defects, posing significant challenges in surgical reconstruction. Osteochondral defects, in particular, may progress to osteoarthritis (OA) if not properly addressed. We present a rare case of a 25-year-old male who sustained multiple fractures, including a complex intra-articular distal tibial fracture with osteochondral and metaphyseal bone loss. Due to concurrent wrist trauma requiring arthrodesis, autologous cartilage from resected proximal carpal bones was harvested and used to reconstruct the tibial articular defect. The metaphyseal defect was filled with autologous iliac crest bone graft, and internal fixation was achieved via anteromedial and lateral plating. The patient was followed for 2 years. No post-operative complications, such as infection or wound problems, were observed. Functional evaluation using the Foot and Ankle Outcome Score revealed significant improvements in all subscales, with no range of motion limitations in the ankle. Autologous cartilage transfer from carpal bones may offer a viable alternative for treating distal tibial osteochondral defects, especially in cases where simultaneous wrist arthrodesis is indicated. This approach provides a novel solution for joint surface reconstruction and may prevent long-term complications such as post-traumatic OA.