Rotational deformities after fractures of the femoral shaft in childhood.

Sixty-two patients with femoral fractures treated conservatively have been studied over an interval of 1 to 6 years. Rotational deformity was assessed by a radiological method of anteversion measurement. The degree of rotational deformity following fracture ranged from 10 degrees to 33 degrees in just over one-third of the whole group; by later assessment there was no evidence of spontaneous correction during growth. In view of the possibility of early complaints, e.g. pain and fatigue in the abnormally rotated extremity, and the potential risk of subsequent arthrosis, we consider that rotational deformity over 20 degrees ought to be avoided. It is suggested that use of the extension table of Weber is the most satisfactory conservative method of treatment of femoral fractures in childhood (Weber, 1969). This enables correction of significant rotation deformity during treatment under radiographic control.