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Archives of Orthopaedic and Trauma Surgery

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21.04.2021 | Trauma Surgery

CT analysis of femoral malrotation after intramedullary nailing of trochanteric fractures

verfasst von: Jakub Maléř, Valér Džupa, Michal Buk, Martin Michna, Jiří Marvan, Jiří Skála-Rosenbaum

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 8/2022

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Abstract

Purpose

Functional results after internal fixation of trochanteric femoral fractures may be negatively affected by healing in a non-physiological position. The aim of this study was to evaluate the occurrence and severity of femoral malrotation after nailing of trochanteric fractures.

Materials and methods

The authors conducted a prospective study focused on a CT analysis of malrotation after intramedullary nailing of trochanteric fractures (AO 31A1-3) in 101 patients. We recorded the type of fracture, method of anesthesia, scheduled surgery vs. acute surgery, and the surgeon’s experience as possible risk factors for limb malrotation after trochanteric fracture surgeries.

Results

The average extent of malrotation was 9° of internal rotation ranging from 29° of external to 48°of internal rotation. In 35% of patients, we observed a rotation greater than 15°, and in 15 patients (15%), the rotation was greater than 25°. The risk of significant internal malrotation was significantly higher than external malrotation (37 vs. 4 patients). None of the factors observed proved to be statistically significant. The effect of general anesthesia and the type of intertrochanteric fracture came closest to having a significant effect on rotational error.

Conclusion

Improper reduction of a trochanteric fracture is a common problem that can lead to femur malrotation. In our study, a rotational error greater than 15° occurred in 35% of the patients, but none of the monitored factors represented a statistically significant risk for this complication.

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Titel: CT analysis of femoral malrotation after intramedullary nailing of trochanteric fractures
verfasst von: Jakub Maléř
Valér Džupa
Michal Buk
Martin Michna
Jiří Marvan
Jiří Skála-Rosenbaum
Publikationsdatum: 21.04.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 8/2022
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-021-03902-3

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CT analysis of femoral malrotation after intramedullary nailing of trochanteric fractures

Abstract

Purpose

Materials and methods

Results

Conclusion

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