Dynamic condylar screw fixation for comminuted proximal femur fractures

ABSTRACT

To evaluate the success of dynamic condylar screw [DCS] fixation for comminuted proximal fractures of femur in adults. Case series. Orthopedics Department CMH Lahore, from October 2009 to September 2010. This study included 20 males and 9 female patients with age ranging 25 to 65 year [mean 44 year] who presented with closed comminuted proximal femur fractures [Evan's classification type I c to e and type II]. All the patients underwent indirect fracture reduction on a standard orthopedic traction table under C-arm guidance and this was followed by inter-fragmentary stabilization with dynamic condylar screw construct [AO Synthes]. Functional outcomes were assessed using the Harris hip score. Post operative patients' evaluation was continued for 12 months. The average time to full weight bearing was 14 weeks. [range 12-16 weeks]. The mean time to union was 16 [range, 13-22] weeks. The included non-union, delayed atrophic union, implant failure, limb length discrepancy, and knee stiffness. According to the Harris hip score, functional results were excellent in 21 and good in 7, whereas one patient showed poor result. The mean Harris hip score was 88 [range 80-99]. Our results of DCS fixation for comminuted proximal femoral fractures indicated that it is a very practical and a satisfactory method of fixation. Minimal striping of the soft tissues and gentle fragmentary manipulation intra operatively remained the pivotal factors for good fracture healing and functional outcome: