Abstract
Femoral shaft fractures are one of the most common injuries in trauma patients. The gold standard treatment consists of closed reduction and intramedullary nailing, providing a high fracture healing rate and allowing early mobilization. However, rotational malalignment is a well-known complication following this procedure, and excessive femoral anteversion or femoral retroversion can trigger functional complaints. In order to achieve the ideal degree of femoral rotation, a 3D planning and printing cutting guides procedure was developed to correct femoral malrotation. A patient series with malalignment after a femoral diaphyseal fracture was operated on with the customized guides and evaluated in this study. Computed tomography scans were performed to accurately determine the number of degrees of malrotation, allowing the design of specific and personalized surgical guides to correct these accurately. Once designed, they were produced by 3D printing. After surgery with the customized guides to correct femoral malrotation, all patients presented a normalized anteversion angle of the femur (average −10.3°, range from −5° to −15°), according to their contralateral limb. These data suggest that the use of customized cutting guides for femoral osteotomy is a safe and reproducible surgical technique that offers precise results when correcting femoral malrotation.
Highlights
Femoral shaft fractures (FSF) are one of the most common injuries in trauma patients, with an incidence of between 10 and 21 per 100,000 people per year [1,2]
The gold standard treatment for FSF consists of closed reduction and intramedullary nailing
This complication may occur in 28% of the patients [8], other studies showed that the incidence of malrotation after intramedullary nailing for femur fractures ranges from 19% to 56% [9,10,11]
Summary
Femoral shaft fractures (FSF) are one of the most common injuries in trauma patients, with an incidence of between 10 and 21 per 100,000 people per year [1,2]. The gold standard treatment for FSF consists of closed reduction and intramedullary nailing This technique provides a high fracture healing rate and allows early mobilization [4,5]. A rotational malalignment is a well-known complication following this procedure, and a difference in rotation greater than 15◦ compared with the healthy side can be responsible for functional complaints [6,7]. This complication may occur in 28% of the patients [8], other studies showed that the incidence of malrotation after intramedullary nailing for femur fractures ranges from 19% to 56% [9,10,11]. Femoral malrotation is calculated by measuring the femoral version, which is defined according to the technique described by Jeanmart et al, determining the angle between a line tangential
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
