The dynamic condylar screw in the management of subtrochanteric fractures: does judicious use of biological fixation enhance overall results?
Manzoor Ahmed Halwai, Shabir A Dhar, Mohammed Iqbal Wani, Mohammed Farooq Butt, Bashir Ahmed Mir, Murtaza Fazal Ali, Imtiyaz Hussain Dar
Keywords :
The dynamic condylar screw, Subtrochanteric fracture, Biological fixation
Citation Information :
Halwai MA, Dhar SA, Wani MI, Butt MF, Mir BA, Ali MF, Dar IH. The dynamic condylar screw in the management of subtrochanteric fractures: does judicious use of biological fixation enhance overall results?. 2007; 2 (2-3):77-81.
Subtrochanteric fractures are fraught with certain anatomic, biologic and biomechanical challenges. Evolution of implants like the Gamma nail, fixed-angle nail plates, compression hip screws and dynamic hip screws with trochanteric stabilization plates underlines a persistent quest for a better implant. We studied the dynamic condylar screw DCS as an implant on a series of 30 consecutive patients with subtrochanteric fractures. Our purpose was to assess this implant as a panacea for subtrochanteric fractures. All cases of AO type A and B were anatomically fixed, whereas type C was biologically plated. The idea was to assess the applicability and adaptability of the DCS. Fractures in 29 cases united, with one patient suffering from an implant failure. There were 17 excellent, 5 good, 5 fair and 3 poor results. The DCS is a definite advance over previous methods of treatment; when combined with the utilization of biological fixation techniques for comminuted fractures, can be relied upon to treat all types of subtrochanteric fractures.
Lavelle David G (2003) Campbells operative orthopaedics, 10th edn. Mosby, St. Louis, p 2897
Asher MA, Tippet JW, Rockwood CA, Zilber S (1976) Compression fixation of subtrochanteric fractures. CORR No 117: June
Sims SH (2002) Treatment of complex fractures. Orthop Clin North Am 33(1):1-12
Wadell JP (1979) Subtrochanteric fractures of femur: a review of 130 patients. J Trauma 19(8):582-92
Kinast C, Bolhofner BR, Mast JW, Ganz R (1989) Subtrochanteric fractures of the femur. Results of treatment with the 950 condylar blade plate. Clin Orthop 238:122
Muller ME, Nazarian S, Koch P et al (1990) The AO classification of fractures of long bones. Springer, Berlin, p 116
Radford PJ, Howell CJ (1992) The AO dynamic condylar screw for fractures of the femur. Injury 23:89-93
Bedi A, Le TT (2004) Subtrochanteric femur fractures. Orthop Clin North Am 35:473-483
Tencer AF, Johnson KD, Johnston DW et al (1984) A biomechanical comparison of various methods of stabilization of subtrochanteric fractures of femur. J Orthop Res 2:297-305
Seinsheimer F (1978) Subtrochanteric fractures of the femur. JBJS 60-A(3):300-306
Velasco UR, Comfort TH (1978) Analysis of treatment problems in subtrochanteric fractures of the femur. J Trauma 18(7):513- 523
Warwick DJ, Crichlow TPKR, Langkamer VG et al (1995) The dynamic condylar screw in the management of subtrochanteric fractures of the femur. Injury 26(4):241-244
Nungu KS, Olerud C, Rehnberg L (1993) Treatment of subtrochanteric fractures with the AO dynamic condylar screw. Injury 24(2):90-2
Schatzker J, Mahomed N, Schiffman K, Kellam J (1989) Dynamic condylar screw: a new device. J Orthop Trauma 3:124
Blatter G, Janssen M (1994) Treatment of subtrochanteric fractures of the femur: reduction on the traction table and fixation with dynamic condylar screw. Arch Orthop Trauma Surg 113(3):138-41
Perren SM (1989) Trends in the internal fixation. Potential, limits and requirements. Injury 30(suppl 2):SB2-SB4 [Editorial]
Kulkarni SS, Moran CG (2003) Results of dynamic condylar screw for subtrochanteric fractures. Injury 34:117-122
Vaidya SV, Dholakia DB, Chaterjee A (2003) The use of a dynamic condylar screw and biological reduction techniques for subtrochanteric femur fracture. Injury 34:123
Pakuts AJ (2004) Unstable subtrochanteric fractures gamma nail versus dynamic condylar screw. Int Orthop 28(1):21-4. Epub 2003 Aug 26
Ruff ME, Lubbers LM (1986) Treatment of subtrochanteric fractures with a sliding plate device. J Trauma 26:75