Rotational Deformities After Femoral Shaft Fractures in Childhood:A Retrospective Study 27–32 Years after the Accident

Abstract

Fifty femoral shaft fractures sustained in childhood and for the most part treated conservatively were studied in retrospect 27-32 years after the accident, with special reference to rotational deformity. Femoral rotation was measured by means of so-called anteversion X-rays according to Dunn-Rippstein, and the same radiological examination was carried out in a control group of 100 adult volunteers. The L/R differences in femoral rotation were studied in the patient group in comparison with the control group. Persistent rotational dislocation was found in only one case, and had had no demonstrable untoward consequences. The established view that rotational dislocation is incapable of spontaneous correction is refuted with aid of clinical and experimental data from the literature and personal observations. It is concluded that, in the patients studied, good results have been obtained by the conventional traction methods of Bryant and Russel. The use of the so-called "Weber Bock" to replace these methods is therefore not recommended.

Three-dimensional biplanar radiography as a new means of accessing femoral version: a comparitive study of EOS three-dimensional radiography versus computed tomography

“…However, until the long-term effects of radiation exposure are better understood, our ability to perform long-term cost analysis is limited. Finally, it has been shown that femoral version in adults and children [1,24] can vary as much as 15-18°from one side to another, but it is unknown how much femoral version alteration becomes clinically relevant. For this reason, it is unclear whether the error in BR 3D reconstruction measurements (4.0-10.1°) has any clinical relevance.…”

“…On average, there is 30-40°of anteversion at birth, and it decreases with time to approximately 10-15°in skeletally mature individuals. However, there can be significant variation between individuals and even between contralateral sides [1][2][3].…”

“…Femoral version contributes to the normal stability and function of the hip and knee joints and is an important clinical factor in many pathologic conditions, including torsional syndromes and their sequelae [2], femoral fractures [1], developmental dysplasia of the hip [4], hip joint arthroplasty [5,6], Legg-Calve-Perthes disease [7] and slipped capital femoral epiphysis [8,9].…”

Rotational malalignment after closed intramedullary nailing of femoral shaft fractures and its influence on functional outcome

“…[23][24][25] Ante version differences less than 10° are normal variations. 8,26 Between 10° and 14° is a somewhat gray zone referred to as possible deformity, and 15° or more anti version difference between the affected and unaffected side is considered as a true torsional deformity.…”

Spontaneous correction of femoral torsion: Diaphyseal osteotomies studied in kittens

“…However, other authors have reported correction by growth of torsional deformities (Laer 1977, Verbeek 1979, Brouwer et al 1981, Hagglund et a]. 1983.…”