title: Leg length discrepancies in adult femoral shaft fractures treated with intramedullary nailing.
abstract: BACKGROUND
  To evaluate the leg length discrepancy (LLD) retrospectively in adult femoral shaft fractures treated with intramedullary nailing (IMN).
  
  
  METHODS
  Sixty-three patients (58 male, 5 female; mean age 29.9+/-12.4; range 15 to 77 years) were included in the study. Fractures were identified according to the Winquist-Hansen (W) system and AO classification. 16 W0, 18 WI, 16 WII, 7 WIII, and 6 WIV fractures and 35 type A, 22 type B, and 6 type C fractures were repaired. Thirty-one (49.2%) patients had multiple injuries. Fourteen patients sustained an open fracture. LLDs were measured on physical examination and using orthoroentgenography.
  
  
  RESULTS
  The mean follow-up was 90.2+/-29.9 (39-193) months. The mean LLD was 12.3+/-15.2 [12-(-60)] mm using orthoroentgenography and 12.9+/-13.7 [10-(-60)] mm according to manual measurement. In seven cases, no LLD was observed. Twenty-seven shortenings and one lengthening were observed in the 28 femurs with a discrepancy greater than 10 mm (44.4%). There was no statistical correlation between LLD and open or closed fracture (r=0.02, p=0.86), polytrauma (r=-0.09, p=0.47), or delayed surgery (p=0.31), but there was a tendency to a greater discrepancy in comminuted fractures (WIII, IV) (r=0.33, p=0.007).
  
  
  CONCLUSIONS
  LLD may be seen in high rates in adult femoral shaft fracture cases treated with IMN. Static IMN following absolute restoration of the length may prevent this problem in femoral diaphysis fractures, especially comminuted WIII and IV types.
authors: Department of Orthopedics and Traumatology, Tepecik Training and Research Hospital, Izmir, Turkey. lkarapinar@yahoo.com
authors: Levent
authors: L
authors: Karapinar
authors: Ahmet
authors: A
authors: Kaya
authors: Hasan
authors: H
authors: Oztürk
authors: Taşkin
authors: T
authors: Altay
authors: Cemil
authors: C
authors: Kayali
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects* / Q000379:methods; D018460:Fractures, Comminuted / Q000601:surgery; D006801:Humans; D007870:Leg Length Inequality / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult