Affiliations: [a] Trauma Department, Hannover Medical School, Hannover, Germany | [b] Orthopaedic Department, Hospital for Special Surgery, New York, NY, USA
Correspondence:
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Address for correspondence: Nael Hawi, MD, Trauma Department, Hannover Medical School, Carl Neuberg Str. 1, 30625 Hannover, Germany. Tel.: +49 511 532 2050; Fax: +49 511 532 5877; E-mail: hawi.nael@mh-hannover.de.
Abstract: Femoral malrotation is a common complication after internal fixation of a femoral shaft fracture. The only valid, objective monitoring method is computer tomography-assisted torsion measurement between the proximal and distal femur; unfortunately, this can only be carried out postoperatively. A difference of 15° compared to the contralateral femur is seen as an indication for revision. With the development of computer-assisted surgery, new possibilities for performing torsion control and correction intraoperatively has been introduced. These methods also allow for navigation-assisted definition of the optimal incision site, intramedullary access, femoral nail and interlocking. The main problem lies in the extra time of surgery, which is due to performing all the steps of the surgery navigated. The solution for this problem is “hybrid navigation”, in which the surgeon can select the steps he needs from the navigation system, depending on his experience or surgical technique.
