TY - JOUR
T1 - Rotational malalignment after intramedullary fixation of trochanteric fractures
AU - Annappa, Rajendra
AU - Mittal, Harramb
AU - Kamath, Surendra Umesh
AU - Rai, Santhosh
AU - Suresh, Pooja Kundapur
AU - Mohammed, Nabeel
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Introduction: Rotational malalignment after intramedullary fixation of fractures of the shaft of femur and tibia has been assessed by many studies but less frequently after intramedullary fixation of intertrochanteric fractures. Intertrochanteric fractures are managed by closed reduction in a traction table and fixation either by dynamic hip screw or proximal femoral nail under image intensifier. Reduction is checked intraoperatively by antero-posterior and lateral views with image intensifier in which rotational alignment cannot be assessed. Aim: To study the rotational malalignment in the operated limb compared to normal limb by computed tomography (CT). Materials and Methods: A prospective study was conducted on 70 patients at Kasturba Medical College and allied hospitals with intertrochanteric fractures with intramedullary fixation and with normal anatomy on opposite side. Postoperative CT with pelvis and knee was done and compared for rotational alignment. Results: The mean anteversion on the normal side was 13.20. The mean anteversion on the operated side was 15.70. The mean rotational malalignment was 9.70; there was internal rotational deformity in 41 cases (58.6%) and external rotational deformity in 29 cases (41.4%) with Grade III malrotation in 17 (24.3%) cases. Conclusion: Rotational malalignment postoperatively is frequently present and needs to be corrected intraoperatively by improving assessment methods.
AB - Introduction: Rotational malalignment after intramedullary fixation of fractures of the shaft of femur and tibia has been assessed by many studies but less frequently after intramedullary fixation of intertrochanteric fractures. Intertrochanteric fractures are managed by closed reduction in a traction table and fixation either by dynamic hip screw or proximal femoral nail under image intensifier. Reduction is checked intraoperatively by antero-posterior and lateral views with image intensifier in which rotational alignment cannot be assessed. Aim: To study the rotational malalignment in the operated limb compared to normal limb by computed tomography (CT). Materials and Methods: A prospective study was conducted on 70 patients at Kasturba Medical College and allied hospitals with intertrochanteric fractures with intramedullary fixation and with normal anatomy on opposite side. Postoperative CT with pelvis and knee was done and compared for rotational alignment. Results: The mean anteversion on the normal side was 13.20. The mean anteversion on the operated side was 15.70. The mean rotational malalignment was 9.70; there was internal rotational deformity in 41 cases (58.6%) and external rotational deformity in 29 cases (41.4%) with Grade III malrotation in 17 (24.3%) cases. Conclusion: Rotational malalignment postoperatively is frequently present and needs to be corrected intraoperatively by improving assessment methods.
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U2 - 10.7860/JCDR/2018/34130.12357
DO - 10.7860/JCDR/2018/34130.12357
M3 - Article
AN - SCOPUS:85057595413
SN - 2249-782X
VL - 12
SP - RC05-RC08
JO - Journal of Clinical and Diagnostic Research
JF - Journal of Clinical and Diagnostic Research
IS - 12
ER -