Malrotation following Ender nailing.

External malrotation is a frequent complication following Ender nailing. Biomechanical studies demonstrate that the standard Ender nail tends to produce external malrotation when the fracture is unstable. This type of malrotation does not develop to the same degree if the nails are bent into a 25 degree angle of anteversion. The anteversion nail follows the natural anteversion curve of the upper femur and does not build up a torsional stress that might be released in an unstable fracture situation. It is recommended that anteversion nails be used in condylocephalic nailing.