Treatment of subtrochanteric fracture of the femur with dynamic condylar screw / 中国矫形外科杂志

ABSTRACT

[Objective]To evaluate the clinical value in treatment of subtrochanteric fracture of the femur by dynamic condylar screw(DCS).[Method]This study retrospectively reviewed 29 patients who suffered from subtrochanteric fracture of the femur.There were 18 males,11 females,with an average age of 52.2 years.Seven cases were caused by traffic accident,8 cases caused by falling from hight,14 cases caused by pedestrian injury.According to Seinsheimer classification,there were 5 cases of typeⅡ(2 of typeⅡB,3 of typeⅡC),12 cases of typeⅢ(7 of type ⅢA,5 of type ⅢB),5 cases of type Ⅳ,7 cases of type Ⅴ.All patients accepted the treatment with traction reduction and dynamic condylar screw fixation and were fellowed up for 9～24 months(average 16 months).Outcoms were assessed by Sanders traumatic hip rating scale and postoperative complications were analyzed.[Result]All patients obtained bone union in average 3.5 months(3～5 months),Only one case who had obtained bone union suffered subtrochanteric refracture 16 months after operation because of plate breakage.All patients were encouraged to early exercise and walk by nonweight-bearing.There was no postoperative infection,deep venous thrombosis,internal fixation loosening,limb shortening and varus deformity.According to sanders traumatic hip rating scale,18 cases were excellent,10 cases were good,1case was fair.The excellent and good rate was 96.5%.[Conclusion]In treatment of subtrochanteric fracture of the femur,DCS not only maintain satisfying reduction with reliable fixation,but also prevent femoral shortening,rotation and varus deformity,thus get good curative effect,fast recovery,satisfying function and so on.So it is one of the best choices to heal subtrochanteric fracture.