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A five-year-old girl received a diagnosis of Ewing's sarcoma of the distal femur after she noticed a painless mass behind her left knee. The tumor had not metastasized at the time of the diagnosis. The patient was treated with aggressive chemotherapy and wide surgical excision of the tumor with a rotationplasty. The middle and distal portions of the tibia, along with the foot and ankle, were rotated 180 degrees and attached to the proximal femur so that the ankle joint could act as the knee joint. The clinical images shown (Panels A and B) were obtained seven years after the diagnosis. The patient finished her last round of chemotherapy six years ago and has been tumor-free since that time. She is healthy and is very active in cheerleading and gymnastics. She also has an excellent functional gait, as shown in the accompanying video.
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