{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T08:01:05Z","timestamp":1769500865069,"version":"3.49.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To prevent leg length discrepancy (LLD) after locked femoral nailing in patients with comminuted femoral shaft fractures.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Prospective consecutive case series aimed at quality improvement.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Level 1 Trauma Center<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients:<\/jats:title>\n            <jats:p>Ninety-eight consecutive patients with a comminuted femoral shaft fracture underwent statically locked intramedullary nailing, with a focused attempt at minimizing LLD during surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Intervention:<\/jats:title>\n            <jats:p>A computed tomography scanogram of both legs was performed on postoperative day 1 to assess for residual LLD. Patients were offered the option to have LLD &gt;1.5 cm corrected before discharge.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main Outcome Measure:<\/jats:title>\n            <jats:p>LLD &gt;1.5 cm.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Twenty-one patients (21.4%) were found to have an LLD &gt;1.5 cm. An LLD &gt;1.5 cm occurred in 10\/55 (18%) antegrade nail patients and 11\/43 (26%) retrograde nail patients (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.27). No difference was noted based on the mechanism of injury, surgeon training and OTA\/AO type B versus C injury. Ninety of 98 patients left with &lt;1.5 cm LLD, 13\/21 had a correction all to \u22640.6 cm, and 8 decided to accept the LLD and declined early correction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>No patient left the hospital with an LLD &gt;1.5 cm after locked intramedullary nailing for a comminuted femoral shaft fracture without being informed and the option of early correction. We recommend using a full-length computed tomography scanogram after IM nailing of comminuted femur fractures to prevent iatrogenic LLD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000001135","type":"journal-article","created":{"date-parts":[[2018,2,2]],"date-time":"2018-02-02T16:42:42Z","timestamp":1517589762000},"page":"256-262","source":"Crossref","is-referenced-by-count":9,"title":["Minimizing Leg Length Discrepancy After Intramedullary Nailing of Comminuted Femoral Shaft Fractures: A Quality Improvement Initiative Using the Scout Computed Tomography Scanogram"],"prefix":"10.1097","volume":"32","author":[{"given":"Petra","family":"Gheraibeh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul","family":"Vaidya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Hudson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Meehan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick","family":"Tonnos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anil","family":"Sethi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20230828","doi-asserted-by":"crossref","first-page":"529","DOI":"10.2106\/00004623-198466040-00006","article-title":"Closed intramedullary nailing of femoral fractures. A report of five hundred and twenty cases","volume":"66","author":"Winquist","year":"1984","journal-title":"J Bone Joint Surg Am."},{"issue":"suppl 1","key":"R2-20230828","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.injury.2013.10.046","article-title":"Intramedullary nailing of long bone fractures: sixty years of evolution but what the future holds?","volume":"45","author":"Gradl","year":"2014","journal-title":"Injury"},{"key":"R3-20230828","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1097\/00005131-200102000-00003","article-title":"Angular malalignment after intramedullary nailing of femoral shaft fractures","volume":"15","author":"Ricci","year":"2001","journal-title":"J Orthop Trauma."},{"key":"R4-20230828","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1016\/j.injury.2012.03.022","article-title":"CT scanogram for limb length discrepancy in comminuted femoral shaft fractures following IM nailing","volume":"43","author":"Vaidya","year":"2012","journal-title":"Injury"},{"issue":"6 suppl 2","key":"R5-20230828","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.arth.2007.05.003","article-title":"Medical malpractice in hip and knee arthroplasty","volume":"22","author":"Upadhyay","year":"2007","journal-title":"J Arthroplasty."},{"key":"R6-20230828","first-page":"256","article-title":"Leg length discrepancies in adult femoral shaft fractures treated with intramedullary nailing","volume":"15","author":"Karapinar","year":"2009","journal-title":"Ulus Travma Acil Cerrahi Derg."},{"key":"R7-20230828","first-page":"455","article-title":"A simple and accurate method for determining leg length in primary total hip arthroplasty","volume":"35","author":"Iagulli","year":"2006","journal-title":"Am J Orthop (Belle Mead NJ)."},{"key":"R8-20230828","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1097\/BLO.0b013e31804d2355","article-title":"Computer navigation allows for accurate reduction of femoral fractures","volume":"460","author":"Weil","year":"2007","journal-title":"Clin Orthop Relat Res"},{"key":"R9-20230828","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1007\/s00402-009-0871-3","article-title":"Computer-assisted antetorsion control prevents malrotation in femoral nailing: an experimental study and preliminary clinical case series","volume":"129","author":"Gosling","year":"2009","journal-title":"Arch Orthop Trauma Surg."},{"key":"R10-20230828","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1016\/j.injury.2011.06.023","article-title":"Navigation in femoral-shaft fractures\u2014from lab tests to clinical routine","volume":"42","author":"Wilharm","year":"2011","journal-title":"Injury"},{"key":"R11-20230828","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1016\/j.injury.2014.05.039","article-title":"Radiological outcome and intraoperative evaluation of a computer-navigation system for femoral nailing: a retrospective cohort study","volume":"45","author":"Hawi","year":"2014","journal-title":"Injury"},{"key":"R12-20230828","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1097\/00005373-199502000-00011","article-title":"Femoral torsion after interlocked nailing of unstable femoral fractures","volume":"38","author":"Tornetta","year":"1995","journal-title":"J Trauma."},{"key":"R13-20230828","doi-asserted-by":"crossref","first-page":"1955","DOI":"10.1007\/s00264-015-3040-z","article-title":"Accuracy of low dose CT scanogram for measurement of femoral version","volume":"40","author":"Hultman","year":"2016","journal-title":"Int Orthop."},{"key":"R14-20230828","doi-asserted-by":"crossref","first-page":"2745","DOI":"10.1007\/s11999-013-3292-0","article-title":"Assessing leg length after fixation of comminuted femur fractures","volume":"472","author":"Herscovici","year":"2014","journal-title":"Clin Orthop Relat Res."},{"key":"R15-20230828","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1016\/j.injury.2014.01.024","article-title":"Comparing femoral version after intramedullary nailing performed by trauma-trained and non-trauma trained surgeons: is there a difference?","volume":"45","author":"Ayalon","year":"2014","journal-title":"Injury"}],"container-title":["Journal of Orthopaedic Trauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00005131-201805000-00008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T06:13:10Z","timestamp":1693203190000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00005131-201805000-00008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5]]},"references-count":15,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1097\/bot.0000000000001135","relation":{},"ISSN":["0890-5339"],"issn-type":[{"value":"0890-5339","type":"print"}],"subject":[],"published":{"date-parts":[[2018,5]]}}}