Use of Inherent Anteversion of an Intramedullary Nail to Avoid Malrotation in Comminuted Femur Fractures: A Prospective Case- Control Study

Journal of Orthopaedic Trauma
Rahul VaidyaIan Hudson

Abstract

To (1) evaluate using the inherent anteversion of a second or third generation femoral nail to set the version of the femur during locked intramedullary nailing of comminuted femoral shaft fractures (Espinosa Technique [ET]) and compare it with our traditional method (traditional group [TG]) and (2) assess the variation of anteversion because of the inherent play in the nail itself. A prospective IRB-approved study. Academic US Level 1 Trauma Center. Fifty-two consecutive patients with comminuted femur fractures all completed the study. The first 27 patients had the anteversion determined using the patellar shadow and lesser trochanter (TG), and the next 25 patients were treated by ET. Computed tomography scanogram for femoral anteversion and length in the normal versus operated femur. A >15 degree difference from native to operated legs was found in 8/27 TG (29%, 95% CI 15.3%-54.2%), with a mean difference of 11.6 ± 10.2 degrees (95% CI 8.8-16.17) verses 1/25 in the ET group (2.5%, 95% CI 0%-15.3%), with a mean difference of 4.8 ± 6.2 degrees (95% CI 1.38-8.9) (P = 0.0068). There was a 5 degree variability in our ability to center the proximal locking screw in the femoral head and 5 degrees variation in distal locking. The inh...Continue Reading

References

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Dec 5, 1998·Journal of Orthopaedic Trauma·K H YangJ H Park
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Nov 18, 2015·International Orthopaedics·Kristi Lynn HultmanJason Benjamin Wynberg
Apr 1, 2016·Journal of Orthopaedic Trauma·Alexander BrunnerFranz Kralinger

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Citations

Apr 3, 2020·Archives of Orthopaedic and Trauma Surgery·T StubigT Omar Pacha
Apr 22, 2021·Archives of Orthopaedic and Trauma Surgery·Jakub MaléřJiří Skála-Rosenbaum

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