Biological fixation of subtrochanteric intertrochanteric femoral fractures using dynamic condylar screw

Thirty-five subtrochanteric fractures type V Seinsheimer and type IIA and IIb Rausell -Taylor with intertrochanteric extension to the piriformis fossa were treated in this study. All fractures except 2 were fixed during the first week after injury using indirect reduction by traction on orthopedic traction table under image intensifier. No bone graft was used even in those fractures having significant comminution of the medial cortex, but all attempts were paid to avoid any exposure of the site of comminution. All fractures had united within 12 weeks postoperatively without loss of fixation or reduction. One case only [Type IIB] united with 10C varus deformity. There was only one case of early postoperative deep wound infection that responded to wound debridement, suction irrigation and antibiotic for 6 weeks and the fracture united 12 weeks postoperatively. The technique is easy with excellent results in spite of the stresses on the medial femoral cortex with relatively low complications rate, if meticulous biological principles are followed