Objectives: The rotational alignmen

Objectives: The rotational alignment is definitely important in the long bones such as tibias and femurs.We also predict the importance of rotational alignment in the trochanteric fractures. So we measuredtorsional malalignment in trochanteric fracture and anlaysed their risk factors and their clinicalsignificance.Methods: A total of 109 inpatients who had undergone internal fixation following trochanteric fractureand a postoperative pelvic CT scan between 2008 and 2013, with at least one year follow-up, wereselected. Factors that affect torsional malalignment, such as age, gender, fracture stability, injured area,operative time, time of surgery after admission, and ASA status, were investigated. Factors that affect thepatients’ clinical results in malrotation, including ambulation time after surgery, postoperativecomplication rates, pain assessment of VAS one year postoperatively and Koval score, were alsoinvestigated.Results: Of the 109 subjects, torsional malalignment was observed in 28 (25.7%) subjects with a meantorsional malalignment angle of 20.78 (range: 31.28 to 27.18). Torsional malalignment risk factors werefracture stability (p = 0.021) and operative time (p = 0.043). In terms of the time to ambulation aftersurgery, the postoperative complication rates, and the VAS and Koval scores at one year postoperatively,no statistically significant difference was observed between the torsional malalignment patients and thenon-deformity patients.Conclusions: In this study, 25.7% of the patients who had undergone internal fixation followingtrochanteric fracture experienced torsional malalignment. Major factors of the torsional malalignmentwere an unstable fracture and the consequent delay in the operative time. But the torsionalmalalignment was deemed to have no effect on clinical results.