Torsion Deformities after Traction Treatment of Femoral Fractures in Children

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Abstract
The torsion of both femurs was investigated in 55 patients who had been treated 5–13 years earlier at the age of 1–16 years for femoral shaft fractures. By comparing the anteversion angle of the contralateral hips, determined by the Rippstein method, torsion deformities exceeding 10 degrees were found in the fractured femur of 10 patients. The maximum deformity found was + 27 degrees. None of the patients had complaints due to the torsion deformity. Deformities appeared more frequently in patients treated with adhesive overhead traction of the fractured leg than in patients treated with wire traction with the limb on an oblique frame. However, the difference was not highly significant (0.05 < P < 0.10). There was no correlation between age at the time of injury and torsion abnormalities and no correlation between the length of the observation period and the residual deformity, indicating growth correction. Examination of the rotational mobility of the hips was found to be a suitable screening test in the diagnosis of deformities exceeding 10 degrees. Radiological investigation of the anteversion angle of the femoral neck is necessary in the final assessment of a torsion deformity.

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