Forces and torques during fracture reduction: Intraoperative measurements in the femur

Reduction is a crucial step in fracture treatment. We determined intraoperative peak forces and torques during fracture reduction in seven patients with eight fractures of the femoral shaft. All fractures were temporarily stabilized by external fixation. Force and torque measurements were performed during the subsequent intramedullary nailing procedure. A three-dimensional load cell was attached to the distal femur fragment using two Schanz screws. All forces and torques were registered on-line during the reduction process. The maximum resulting force was 411 N, the maximum resulting torque 74 N x m. The highest force was observed along the shaft axis with 396 N for distraction. The maximum torque value was measured around the frontal axis, being 74 N x m for antecurvature. These results may assist the development of new reduction techniques and devices.