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Retrospective Study of Distal Femur Fractures Surgically Treated with Dynamic Condylar Screw

Prabhakar V., Assistant Professor, Department of Orthopaedics, Sapthagiri Institute of Medical Sciences and Research Center, Bangalore, Karnataka 560090, India. , Srinivas Nagendra1 , Prabhakar V.2

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Journal of Orthopedic Education 4(1):p 5-10, Jan-Apr 2018. | DOI: http://dx.doi.org/10.21088/joe.2454.7956.4118.1

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Abstract

Despite the advances in techniques and improvements in surgical implants, treatment of distal femoral fractures remains a challenge. Anatomical reduction of articular surface, stable internal fixation with minimal soft tissue stripping, restoration of limb alignment, early mobilization and ambulation are the pre requisite for good results. Though locking plates appear very promising in these fractures, long term studies are needed. Dynamic condylar screw (DCS) with 950 barrel plate is well established method of treating these fractures. Twenty adult patients who had supracondylar and intercondylar fractures of distal 15 cm of femur treated with DCS were studied, all the twenty fractures united with the average time to healing was 15.6 weeks in, ranging from 12 weeks to 18 weeks. In 5 cases some residual deformity, 3 cases deep infection, five patients had quadriceps lag of less than 100, three of them had ipsilateral lower limb associated fractures. Average knee flexion was 114°; range of flexion was from 1000 to 1250. Six patients in this series had mild pain in the knee. Overall functional results were excellent in 8 (40%) patients, good in 6 (30%) patients, moderate in 3 (15%) patients and poor in 3 (15%) patients. In none of the cases we had loss of fixation or implant failure. DCS augmented with interfragmentary lag screws gives good results in intra articular distal end fractures of femur. Judicious use of bone grafting can reduce the risk of non union in severely communited metaphyseal fractures.

Keywords: Distal Femur Fractures; Dynamic Condylar Screw (DCS). 

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DOI: http://dx.doi.org/10.21088/joe.2454.7956.4118.1

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