Because true neutral rotation of the distal fragment alone is not accurate in preventing malrotation deformity of the femur following intramedullary nailing, we recommend measuring AV in both intact and fractured femurs and correcting rotational malalignment if it exists at the time of femoral nailing. Rotational alignment did not change significantly unless we failed to externally reduce the fracture due to a flexion deformity of the proximal fragment.
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