Case ReportsImpact of Internal Malrotation of the Femur Followed by Derotational Osteotomy as Demonstrated by 3D Gait Analysis A Case ReportOlson, Brooke J. MDa; Lenhart, Rachel MD, PhD; Schmeling, Gregory J. MD; Fritz, Jessica M. PhD Author Information Department of Orthopaedic Surgery, Medical College of Wisconsin, Wauwatosa, Wisconsin aE-mail address for B. Olson: [email protected] Investigation performed at Froedtert Memorial Lutheran Hospital, Milwaukee, WI Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (https://links.lww.com/JBJSCC/B976). JBJS Case Connector 12(4):e22.00384, October-December 2022. | DOI: 10.2106/JBJS.CC.22.00384 Buy Metrics Abstract Case: An 18-year-old man with 48° of internal malrotation of the femur after nailing underwent derotational osteotomy with gait dynamics and electromyography data collected preoperatively and postoperatively. Hip abduction and internal foot progression angles were significantly deviated from normal preoperatively compared with the contralateral side. At 10 months postoperatively, the hip was abducted and externally rotated throughout the entire gait cycle. His Trendelenburg gait had resolved, and he reported no residual functional concerns. Before corrective osteotomy, walking velocity was significantly slower with shorter stride lengths. Conclusion: Significant internal malrotation of the femur impairs hip abduction and foot progression angles as well as gluteus medius activation during ambulation. Derotational osteotomy considerably corrected these values. Copyright © 2022 by The Journal of Bone and Joint Surgery, Incorporated
