Femoral malrotation from diaphyseal fractures results in changes in patellofemoral alignment and higher patellofemoral stress from a finite element model study

Rotational disorders of the distal femur resulted in increased stress on the patellofemoral joint and alignment changes. Malrotation in internal and external rotation might cause patellofemoral pain syndrome from rotations < 10°. Care should be taken especially for internal malrotation in the management of femoral shaft fracture.