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External fixator dog leg fracture after anterior cruciate ligament reconstruction.
An unusual complication of a distal femur external fixation occurred in a 17-year-old female who had a patellectomy for an intra-articular distal femur tumor 3 weeks after a right-sided anterior cruciate ligament reconstruction performed via an arthroscopic anterior transpatellar technique. The external fixation was applied after an attempted reduction of the fracture dislocation by traction and manipulation. A fracture at the lower end of the external fixation was noted 1 week later. At 2 months after the first surgery, the fracture was not united. An anterior cruciate ligament reconstruction was done with a patellar tendon graft at 4 months after the first surgery. At 2 years after the last operation, an autogenous hamstring tendon graft was used to reconstruct the anterior cruciate ligament. The patient was able to walk with an orthosis and use crutches at 4 months after the second operation. The use of an external fixator for a distal femur fracture after a primary patellectomy can lead to complications that can cause significant morbidity and disability. Although external fixation is useful for the treatment of a malignant bone tumor in the distal femur, it should be applied with caution for the fracture or reconstruction of the anterior cruciate ligament.