In femoral shaft fractures treated with intramedullary nail, which technique determines the correct rotational alignment before locking?

• A Comparing the lesser trochanter profile on fluoroscopy to the contralateral side ✓
• B Measuring anteversion with CT scan intraoperatively
• C Clinical assessment of hip range of motion postoperatively
• D Using the nail's rotation-guide attachment for standardized 15° anteversion

Explanation

The most practical intraoperative method for assessing femoral rotation during IM nailing is comparing the lesser trochanter profile on fluoroscopy: when the femur is in neutral rotation, the lesser trochanter has a characteristic profile shape; the contralateral intact femur serves as reference. CT-based measurement is a postoperative or preoperative tool, not feasible intraoperatively for real-time correction. Clinical ROM check is performed after nailing but cannot guide intraoperative adjustment. Using a standardized 15° anteversion guide ignores individual variation and fracture pattern.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.