Wolf H, Schauwecker F, Tittel K
Unfallchirurgie. 1984 Jun;10(3):133-6. doi: 10.1007/BF02585802.
77 patients with previous intramedullary nailing of the femur underwent detailed clinical and roentgenographical examination designed to show the frequency and extent of malrotation following this type of osteosynthesis. In 29% of the cases, more than 10 degrees of torsion deviation was detected on the roentgenogram using the Rippstein technique. An average outward rotation of three degrees was found after nailing. Most of the cases of malrotation occurred after fractures involving the proximal or distal third of the femoral shaft, or when there were more than two large fragments. Transverse and short oblique fractures of the mid-shaft showed superior results. Additional causes of malrotation included the nail being too thin or intraoperative fixation of the fragments occurring in the wrong torsional position. Torsion deviations were the same after using Küntscher- or AO-nails.
77例既往接受股骨髓内钉固定的患者接受了详细的临床和X线检查，旨在显示这种骨固定术后旋转不良的频率和程度。在29%的病例中，使用里普施泰因技术在X线片上检测到超过10度的扭转偏差。钉固定后平均向外旋转3度。大多数旋转不良病例发生在涉及股骨干近端或远端三分之一的骨折后，或存在两个以上大骨折块时。股骨干中段的横行和短斜行骨折显示出更好的结果。旋转不良的其他原因包括钉子过细或术中骨折块在错误的扭转位置固定。使用克氏针或AO钉后的扭转偏差相同。
