Validation of alignment and rotation
Once the bone length has been restored, it is necessary to check for correct alignment and rotation. Rotational alignment can be judged by palpation or by direct visualization of the greater trochanter and femoral trochlea. The distal part of the femur is held in a true lateral position. The position of the greater trochanter and alignment of the adductor magnus muscle are then inspected.
If the femur is correctly aligned in the axial plane the adductor magnus muscle should be aligned and the greater trochanter should be slightly caudal to the long axis of the bone.