Compression nailing for posttraumatic rotational femoral deformities: open versus minimally invasive technique

Between January 1996 and December 1999, we performed 30 derotational osteotomies with compression nailing in 29 patients. In 18 cases (group 1), we used an intramedullary saw (minimally invasive technique), and in 12 cases (group 2), we used a conventional open technique. Follow-up included clinical, conventional radiological, and computer tomographical assessment. The mean angle of derotation was 28.6+/-12.3 degrees in group 1 and 27.6+/-10.7 degrees in group 2. The postoperative mean rotational deviation between left and right side was 7.9+/-6.7 degrees in group 1 and 6.6+/-4.4 degrees in group 2. There were five postoperative complications: two delayed unions, two insufficient corrections, and one infection. There was no significant difference between the groups. When using the minimally invasive technique, we recommend the derotation angle to be marked with Schanz screws instead of Kirschner wires, as soft-tissue resistance may lead to bending of these.