• Arch Orthop Trauma Surg · May 2013

    The effect of rotational deformity on patellofemoral parameters following the treatment of femoral shaft fracture.

    • Ahmet Ozgur Yildirim, Ertuğrul Aksahin, Bulent Sakman, Yusuf Alper Kati, Sefa Akti, Ozgur Dogan, Ahmet Ucaner, and Ali Bicimoglu.
    • Ankara Numune Education and Research Hospital, Orthopaedics and Traumatology Clinics, Konutkent 2 Sitesi B5/C no: 16, Çayyolu/Ankara, Turkey. aoyildirimmd@yahoo.com
    • Arch Orthop Trauma Surg. 2013 May 1;133(5):641-8.

    ObjectiveThe purpose of this study was to investigate the effect of rotational deformities on patellofemoral alignment using the dynamic magnetic resonance imaging method on patients whose femur fractures were treated with intramedullary locking nails.MethodsThe dynamic patellofemoral magnetic resonance imaging results of 33 patients (5 females and 28 males) were reviewed. The mean age of the patients was 36.3 (range 19-61) years. The mean follow-up was 30.2 months (range 24-38). All the patients were given Kujala patellofemoral clinical evaluation scores at the latest follow-up. Those with less than 10° of rotational deformity in either direction were classified as Group A, those with more than a 10° of internal rotation deformity as Group B and more than a 10° of external rotation deformity as Group C. The three groups were then compared regarding to clinical scores. Patellofemoral parameters of operated and contralateral side were also compared in each group.ResultsThere were 14 (42.4 %) patients in Group A, 12 (36.4 %) patients in Group B and 7 (21.2 %) patients in Group C. The mean patella score in Group C (74 ± 7.02) was significantly lower when compared with Group B (87.6 ± 9.9) and group A (90.6 ± 6.1) (p < 0.05). In Group C patients, medial patellar tilt was detected when compared with the intact side. There were no significant changes in patellofemoral position in either Group A or Group B.ConclusionThe results of this study revealed that more than 10° of external rotation deformity could cause a detoriation in the patellofemoral scores. Anatomic reduction of the fracture site should be performed as soon as possible and external rotational deformities should especially be avoided in order to prevent patellofemoral malalignment.

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