title: A corrective osteotomy for post-traumatic malrotation and shortening of the femur.
abstract: Malrotation following femoral nailing is problematic. We describe a new one-stage technique which utilises three components; a cortico-periosteal sleeve, a "dialled-in"correction of rotation and a peg-shaped osteotomy. Seven patients were treated. The mean correction of malrotation was within 5 degrees of the normal side and the mean correction of length was within 8 mm of the normal side. Clinical union was achieved on average by 6 months (range 4-8 months). The only complication was locking screw breakage in one case. The cortico-periosteal sleeve avoids the need for bone graft, surgery is facilitated by the use of "dialled-in" correction of rotation and a peg to correct length.
authors.affiliation: The Institute of Orthopaedics, Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire SY10 7AG, UK.
authors.forename: B C
authors.initials: BC
authors.lastname: Navadgi
authors.forename: J B
authors.initials: JB
authors.lastname: Richardson
authors.forename: V N
authors.initials: VN
authors.lastname: Cassar-Pullicino
authors.forename: R H
authors.initials: RH
authors.lastname: Wade
mesh_terms: D000328:Adult; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D005594:Fracture Fixation, Intramedullary / Q000379:methods; D006801:Humans; D007870:Leg Length Inequality / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D012399:Rotation; D014056:Tomography, X-Ray / Q000379:methods