TORSIONAL DEFORMITY AFTER INTRAMEDULLARY NAILING OF FEMORAL-SHAFT FRACTURES - MEASUREMENT OF ANTEVERSION ANGLES IN 110 PATIENTS

The torsion of both femora was evaluated in 110 patients who had been treated by intramedullary nailing for unilateral femoral shaft fractur es. The anteversion (AV) angle was measured by ultrasound, using a til ted-transducer technique. True torsional deformity, defined as an AV d ifference of 15-degrees or more between sides was found in 21 patients , but only eight had complaints related to the deformity. Three patien ts had reoperations for troublesome external torsional deformities. Of 26 patients with AV differences of 10-degrees to 14-degrees, defined as possible torsional deformity, three had complaints, but none had se rious problems. AV differences of up to 29-degrees were observed in sy mptom-free patients, and no patients with AV differences below 10-degr ees had complaints. Static and dynamic nailing showed almost equal ten dencies to lead to torsional deformity. We conclude that torsional def ormities are usually established during the operation. Many patients t olerate abnormal torsion, but efforts should be made to reduce and sta bilise the femoral shaft fracture with an AV difference of less than 1 5-degrees.