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ORIGINAL ARTICLE
Year : 2003  |  Volume : 37  |  Issue : 3  |  Page : 11

Intra-operative correction of the axial malrotation of diaphyseal fractures of femur treated by locked nailing - A technique


Asthi Arogya Sansthan and Srivastava Fracture and Orthopaedic Institute, Agra, India

Correspondence Address:
A K Varshneya
Consultant Orthopaedic Surgeon, 5A, MG Road, Agra, 282002
India
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Source of Support: None, Conflict of Interest: None


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Femur is a long bone having an inherent torsion due to neck shaft anteversion. This angle is more in foetal life and later reduces to 15 to 17 degrees. The fracture of shaft of femur may be associated with disturbance in the torsion leading to malunion resulting in pain and awkward gait. This mal-rotation can also occur due to nail torsion during introduction of nail, due to faulty locking of proximal and distal screws or due to torsional stresses during healing phase. A new technique was developed to correct malrotation during surgery. The main guide wire was placed on the anterior aspect of the neck of femur defining the ante-version plane. The remaining guide wires follow proximal and distal locking holes. The angle differences were determined with the help of plumb line and protractor. Fifteen patients were treated with this simple technique and followed up for two years or until the fracture healed the clinical examination of the internal and external rotation of the limb showed variation of 5 to 10 degrees, which was acceptable.


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