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Femoral malrotation after surgical treatment of femoral shaft fractures in children: a retrospective CT-based analysis

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Abstract

Background

Rotational malalignment is an important and not always avoidable complication after surgical treatment of femoral shaft fractures. The purpose of this study was to determine the incidence of rotational malalignment in children after surgical treatment of femoral shaft fractures and to identify potential patient- and treatment-related risk factors based on data obtained from CT scans.

Methods

We conducted a retrospective analysis of all patients aged less than 15 years with femoral shaft fractures admitted to our level 1 trauma centre between January 2004 and July 2014. Patients having obtained postoperative CT scans were included for the determination of rotational malalignment. A difference of greater than 15° in femoral torsion between both legs was considered as clinically relevant. Additionally, demographic data and clinical information such as fracture type, treatment method, fluoroscopy time and operating time were reviewed.

Results

A total of 24 patients were enrolled in this study. Clinically relevant femoral malrotation was identified in 10 patients (41.6%). Surgical revision was performed in 7 patients (29.2%). There was no association between the type of surgical procedure, age and the incidence and/or amount of femoral malrotation.

Conclusions

The data suggest that relevant femoral malrotation is an evident problem after surgical treatment of femoral shaft fractures in children that requires critical postoperative assessment.

Level of evidence

Level III, retrospective study.

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Authors and Affiliations

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

    Christian Zeckey, Philipp Mommsen, Musa Citak, Christian Krettek & Mohamed Omar

  2. Limb Reconstruction Unit, Bristol Royal Infirmary, University Hospitals Bristol, Bristol, UK

    Fergal Monsell & Mark Jackson

  3. Department of General, Trauma and Reconstructive Surgery, Ludwig-Maximilians-Universität, München, Germany

    Christian Zeckey

Authors
  1. Christian Zeckey
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  2. Fergal Monsell
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  3. Mark Jackson
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  4. Philipp Mommsen
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  5. Musa Citak
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  6. Christian Krettek
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  7. Mohamed Omar
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Correspondence to Christian Zeckey.

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All authors disclose any financial and personal relationships with other people or organizations that could inappropriately influence their work. There are no conflicts of interest.

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Zeckey, C., Monsell, F., Jackson, M. et al. Femoral malrotation after surgical treatment of femoral shaft fractures in children: a retrospective CT-based analysis. Eur J Orthop Surg Traumatol 27, 1157–1162 (2017). https://doi.org/10.1007/s00590-017-1978-9

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  • DOI: https://doi.org/10.1007/s00590-017-1978-9

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