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Femoral fracture malrotation caused by freehand versus navigated distal interlocking
- Source :
-
Injury . Feb2008, Vol. 39 Issue 2, p176-180. 5p. - Publication Year :
- 2008
-
Abstract
- Summary: Objectives: Rotational deformity following intramedullary nailing of femoral shaft fractures is a clinically significant and underdiagnosed problem. Intraoperative determination of rotation is difficult and may be caused by several factors. The insertion of interlocking screws at a slightly oblique angle may cause a substantial degree of rotational deformity, and this factor has not been evaluated as a cause of malrotation. Methods: In eight paired cadaveric femurs, a midshaft transverse fracture was created and an antegrade nail was placed. The specimens were placed in a custom jig which allowed free rotation of the distal segment. Distal interlocking was performed using either a freehand technique or with navigation, and femoral anteversion was measured before and after interlocking to determine the change caused by the interlocking screw. Results: Freehand placement led to rotational shift up to 7° (mean, 5.8°; range, 4–7°), and navigated insertion led to a change of 2.0° (range, 1–3°; p <0.05). In addition, drill–nail contact and a visible shift of the fracture site occurred in all freehand trials, whereas in the navigation group, contact occurred in only one trial without fracture movement. Conclusions: Freehand distal interlocking may be a substantial cause of rotational deformity, and the assistance of computer navigation systems may improve this malrotation. [Copyright &y& Elsevier]
- Subjects :
- *FEMUR
*FEMORAL artery
*ARTERIES
*BONE fractures
Subjects
Details
- Language :
- English
- ISSN :
- 00201383
- Volume :
- 39
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Injury
- Publication Type :
- Academic Journal
- Accession number :
- 29374205
- Full Text :
- https://doi.org/10.1016/j.injury.2007.06.008