dynamic condylar screw for management of fractures of the distal femur

ABSTRACT

The advantage of the dynamic condylar screw [DCS] over the condylar blade plate [CBP] is to over come the difficulty in adjusting the plate with the femoral shaft, which necessitates strict insertion of the blade portion in the distal femur. A series of 12 patients with type C fracture of the distal femur was reviewed. Technical difficulties were encountered during surgical management of some cases treated with the DCS. The cause of these technical difficulties was analyzed. Intraoperative technical causes, individual variation in the shape of the distal femur and implant/instrumentation factors were suggested and investigated. The first two possibilities were excluded through reviewing intraoperative images and dry cadaveric bone of distal femur. Variation in the shape of two brands of DCS available in the market was found. One design is matching more the original design of CBP and the angle guide of the DCS and subsequently the contour of the distal femur. The other design was not. This point has to be considered to avoid lateralization of the proximal femoral shaft fragment with the less anatomic design. This will ensure anatomic reduction of such difficult fracture and restoration of biomechanics of the distal femur during the process of healing