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Updated: Sep 14, 2025
Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy
Published on: February 17, 2023
Does Femoral Rotation More Closely Mirror the Contralateral Side or a Population Mean of 15 Degrees of Anteversion? A
Megan L Anderson1, Meera M Dhodapkar1, Nicholas G Rhodes2
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
Objectives:
To compare whether femoral version more closely mirrors the contralateral femur or a population norm estimate of 15 degrees of anteversion.
Design:
Radiologic observational study.
Setting:
Level I Trauma Center.
Patient Selection Criteria:
Patients with no history of anatomy-altering femoral injury who underwent bilateral lower extremity computed tomography scans.
Outcome Measures And Comparisons:
Computed tomographies were analyzed to measure femoral version on each side. The asymmetry in femoral version between left and right in each patient (interfemoral rotational variance [IRV]) was recorded. The difference of each femur's version from a proposed population mean of 15 degrees of anteversion was also recorded.
Results:
A total of 219 patients with a mean femoral version of 14.9 degrees ± 10.5 degrees of anteversion were included. Mean IRV was 5.3 degrees, compared with 8.2 degrees of mean variation from the population norm of 15 degrees of anteversion ( P < 0.001). Five percent of patients had IRV >15 degrees compared with 15% that had femoral rotation >15 degrees from the population mean of 15 degrees ( P < 0.001).
Conclusions:
In the setting of a comminuted diaphyseal femur fracture, knowledge of the appropriate target for restoration of rotational alignment is critical. This radiologic cohort study found that on average, femoral version more closely mirrors an individual patient's contralateral femur as opposed to a population norm of 15 degrees of anteversion.
