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Background. An 8-year-old, 18.9 kg, male, intact Kai Ken with a femoral shaft fracture experienced recurrent implant breakage after two fracture reductions using an internal fixator. Objectives. This case report is aimed at using a three-dimensional (3-D) printer to diagnose residual femoral rotational deviation. Implant failures and malunion occurred after two attempts at synthesis. Thus, a 3-D model was designed for preoperative planning of a third surgery. Methods. To evaluate the alignment in the postoperative state after the second surgery, we removed a broken plate from the affected limb. Subsequently, a computed tomography image produced a bone replica using 3-D printing. The distal fragment was fixed and rotated externally by 42°. In addition to correcting the rotational deformity of the femur, we used an intramedullary pin and two locking plates to stabilize the proximal and distal femoral fracture segments. Results. The bone union was confirmed four months after surgery, and no postoperative complications were observed 11 months after surgery. Conclusion. 3-D printing is a valuable tool that increases the accuracy of presurgical planning.

Use of 3-D Models for Surgical Planning of a Malunion in a Dog