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Femoral malrotation following intramedullary nailing in bilateral femoral shaft fractures

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

This study was designed to evaluate the incidence of femoral malrotation in bilateral femoral shaft fractures.

Materials and methods

All closed bilateral femoral shaft fractures in patients aged 18 or over treated between April 2000 and December 2009 were included in the current study. All patients received a postoperative CT-scan to estimate femoral antetorsion and leg length. All bilateral fractures were treated with intramedullary nailing on a radiolucent table. Retrospectively, all patients were analyzed according to the following parameters: (1) femoral antetorsion of both limbs and antetorsion difference in degrees, (2) femoral length discrepancy (cm), (3) incidence of femoral malrotation >15°, (4) revision rate due to femoral malrotation.

Results

A total of 24 patients (11 [45.8%] female; 13 [52.8%] male) with bilateral femoral shaft fractures were included in this study of average age 38 years (median 38 years, range 18–74 years). Clinically relevant malrotation (greater than 15°) was found in 10 cases (41.2%), whereas in 4 cases (40%) a revision surgery was required.

Discussion

Bilateral femoral shaft fractures are associated with a high incidence of clinically relevant femoral malrotation over 15°. Measurement of intraoperative femoral antetorsion in bilateral femoral shaft fractures is quite difficult and currently only feasible postoperatively.

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Authors and Affiliations

  1. Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany

    Mustafa Citak

  2. Trauma Department, Hannover Medical School, Hannover, Germany

    Mussa Arvani, Tobias Hüfner, Christian Krettek & Musa Citak

  3. Orthopaedic Department, Hospital for Special Surgery, New York, USA

    Eduardo M. Suero & Padhraig F. O’Loughlin

Authors
  1. Mustafa Citak
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  2. Eduardo M. Suero
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  3. Padhraig F. O’Loughlin
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  4. Mussa Arvani
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  5. Tobias Hüfner
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  6. Christian Krettek
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  7. Musa Citak
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Correspondence to Mustafa Citak.

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Citak, M., Suero, E.M., O’Loughlin, P.F. et al. Femoral malrotation following intramedullary nailing in bilateral femoral shaft fractures. Arch Orthop Trauma Surg 131, 823–827 (2011). https://doi.org/10.1007/s00402-010-1245-6

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  • DOI: https://doi.org/10.1007/s00402-010-1245-6

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