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RECURRENT ROTATIONAL DEFORMITY OF THE FEMUR AFTER STATIC LOCKING OF INTRAMEDULLARY NAILS

CASE REPORTS

C. Krettek, MD, Professor, Trauma Surgeon1; T. Miclau, MD, Assistant Professor, Orthopaedic Surgeon2; M. Blauth, MD, Privatdozent, Trauma Surgeon1; R. W. Lindsey, MD, Associate Professor, Orthopaedic Surgeon3; C. Donow, MD, Resident in Trauma Surgery1; and H. Tscherne, MD, Professor, Head of Trauma Department1

1 Hannover Medical School, D 30623 Hannover, Germany.
2 Department of Orthopaedic Surgery, San Francisco General Hospital, 1001 Potrero Avenue, Room 3A36, San Francisco, California 94110, USA.
3 Department of Orthopaedic Surgery, Baylor College of Medicine, 6550 Fannin, Suite 2625, Houston, Texas 77030, USA.

Correspondence should be sent to Dr C. Krettek.

Rotational deformity following intramedullary nailing may cause symptoms and require surgical correction by osteotomy. Reamed, locked intramedullary nailing may be performed, but concern about cortical blood supply and potential pulmonary dysfunction from reaming have led many surgeons to limit this and use smaller diameter nails. Slotted nails are commonly used but are less stiff in torsion than the newer unslotted nails, particularly at the lower diameters.

We report two cased of recurrent femoral rotational deformity after using statically interlocked slotted intramedullary nails to correct existing femoral rotational deformities. These patients show that small diameter statically interlocked femoral nails with diminished bone-nail contact must be stiff enough in rotation to avoid potential recurrence.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General