Application of dynamic condylar screw in treatment of intertrochanteric fractures of the femur / 中华创伤杂志

ABSTRACT

Objective To observe the application and efficacy of dynamic condylar screw (DCS) in treating intertrochanteric fractures of the femur and discuss the fixation principle, feasibility, advanta-ges and related issues. Methods A retrospective analysis was done on 23 patients with intertrochanter-ic fractures of the femur treated with DCS from January 2000 to December 2006. Of all, there were 10 elderly patients with different levels of various kinds of internal diseases and 13 young patients injuried by high-energy such as traffic accidents. According to Boyd' s classfication, there was one patient with type Ⅰ fracture, five with type Ⅱ , nine with type Ⅲ and eight with type Ⅳ. After a detailed pre-operative physical examination and targeted treatment, DCS fixation was employed for intertrochanteric fractures of the femur. Results A follow-up for average 18 months showed no death. Early complications occurred in three patients including two with pulmonary infection and one with urinary tract infection, who got cured after proper treatment. There was one patient with long-term complication, post-traumatic arthritis. All 23 patients got bone healing, with excellenee rate of 96% according to Harris criteria. There were no complications like breakage of nails, nonunion, eoxa yarn deformity, shortening or external rotation of the lower limb. Conclusions DCS has advantages of simple operation, reliable fixation and coincidence with biomechanical characteristics and hence is one of ideal methods for treatment of intertrochanteric frac-ture of the femur, especially for subtrochanteric fracture, contrary chanteric fractur, fracture involving large pyriform troehanteric and comminuted fractures of sub-trochanteric lateral os integumentale.