الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Trochanteric fractures account for 60% of all proximal femoral fractures and The majority of these fractures occur in patients over 65 years of age and most commonly affect female, while reporting an increasing incidence due to the aging of the population and correlated bone fragility and osteoporosis (1) .
Trochanteric fractures are commonly stabilized either by intramedullary nailing or plate and screw fixation after reduction on the orthopaedic surgical table under radiological guidance. (4)
The quality of the postoperative reduction of these factures is determined for the most part at the time of the pre- and intraoperative reduction maneuvers. Although the quality of the reduction in the frontal plane is easy to measure and has already been reported in the literature. The same does not hold true for rotational malalignment (4)
The objective of this prospective study was the CT evaluation of the quality of reduction in the horizontal plane.
Postoperatively, a CT with measurement of anteversion in both femoral necks was prescribed. Anteversion of the femoral neck was measured using the method described by Jeanmart et al. (54) And comparing for each femur with the angle between the tangent passing through the line of the posterior condyles and the neck axis (4)
Prospective study including 20 patients operated for a trochanteric fracture between April 2019 and December 2019. Thirteen fractures were treated using DHS plate and screw fixation and 7 with intramedullary nailing. All these patients underwent postoperative CT of the pelvisand knee during their hospitalization with measurement of anteversion of the operated and healthy femoral necks compared with a tangent to posterior femoral condyles. There was malalignment greater than 15° on the operated side compared to the healthy side at 30% of patients.
Conclusion
The rate of rotational malunions of operated trochanteric fractures is very high; 30%, with a majority of external overrotation occurring during reduction maneuvers. The mean rotational malalignment per patient was 14.6°. There was no early disassembly of the osteosynthesis material. These reduction defects had minimal functional consequences. However, this deformity would not necessarily have been tolerable for a younger population. The criteria normally used for reduction of intratrochanteric fractures are insufficient to prevent rotational malalignment. The increase in the number of fluroscopic images (notably with measurement of anteversion of the healthy side) seems to be an advantageous solution to avoid these reduction errors during pre- and intraoperative maneuvers.