[Research progress on correction methods of rotational deformity in closed reduction and intramedullary nail internal fixation of femoral shaft fracture].

Femoral shaft fracture (FSF) is a common fracture in orthopedic practice. Closed reduction and intramedullary nailing, due to their minimally invasive nature and ability to promote fracture healing, have become the mainstream treatment for FSF. However, accurately assessing and correcting rotational deformities during surgery remains a major challenge for this technique. This article reviews the research progress on the assessment and correction of rotational deformities in closed reduction and intramedullary nailing of FSF. Current assessment methods involve the wire-drawing method, femoral neck anteversion angle method, lesser trochanter-femoral shaft tangent method, cortical "step-sign" method, lesser trochanter morphology comparison method, greater trochanter inclination index quantification method, and computer-assisted navigation for reduction. These methods all have their own advantages and disadvantages, and the choice depends on fracture type, hospital resources, and surgical skill. Methods for correcting rotational deformities are mainly divided into two types:closed reduction under traction and percutaneous device-assisted reduction. Closed reduction under traction is easy to perform and suitable for patients with mild shortening deformities. However, it's less effective for patients with extensive shortening, and may cause iatrogenic fractures and nerve injuries. Percutaneous device-assisted reduction can effectively reduce surgical time, blood loss, and radiation exposure. However, it still has limitations when dealing with complex fractures. In recent years, the application of computer-assisted navigation for reduction has offered new possibilities for the precise correction of rotational deformities. However, it's operationally complex and demands high technical skills from surgeons. This article, through a review of existing methods, aims to provide clinicians with more references. It is expected to achieve more accurate rotational deformity correction in the treatment of FSF, thereby improving patients' prognosis.