DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20171568

Comparison of study of a dynamic condylar screw surgery and distal femoral locking compression plate technique in distal femoral fractures

G. Ramachandra Reddy, P. N. Prasad

Abstract


Background: An extensive soft tissue damage, intra articular extension, severe comminution and injury to the quadriceps mechanism make the management of the distal fractures of the femur a significant challenge. The advent of techniques such as dynamic condylar screw surgery and distal femoral locking compression plate technique have improved the, management of these fractures compared to the conventional methods. We in the present study have attempted to compare the outcomes of Dynamic condylar screw surgery and distal femoral locking compression plate technique.

Methods: 72 patients over the age of 20 years who sustained simple or compound factures of the lower 1/3rd of femur and admitted into our hospital were included into the study. The patients were divided into 2 groups, one group who underwent Dynamic condylar screw surgery and the other groups were managed by distal femoral locking compression plate technique.

Results: The most common cause of fracture was road traffic accidents, involving both two wheelers as well as four wheelers (51.4%). 19.4% of the patients had a fall from height and 13.9% had a fall from standing height. The mean operative time in DCS was about 121 minutes in comparison to 118 minutes in the LCP. The average hospital stay and the no of RBCs used were comparable in both the cases. Although the mean number of days for full weight bearing as well as the average time of union of the fracture was marginally lower in LCP than in DCS, it was not significant.

Conclusions: It is therefore observed that both condylar screw and the locking plate are very similar in their performance and satisfaction to the patients, although distal femoral locking plate is better in comminuted distal fracture compared to the dynamic condylar screw fracture management.


Keywords


Femoral fracture, Dynamic condylar screw surgery, Distal femoral locking compression plate surgery

Full Text:

PDF

References


Kolmert L, Persson BM, Romanus B. An experimental study of devices for internal fixation of distal femoral fractures. Clin Orthop Relat Res. 1982;171:290–9.

Martinet O, Cordey J, Harder Y, Maier A, Bühler M, Barraud GE. The epidemiology of fractures of the distal femur. Injury. 2000;31(3):62–3.

Watson-Jones R. Fractures and joint injuries. In: Kregor, Philip, editors. Treatment of Distal Femur. 6th edition. Newdelhi: B.I Churchill Livingstone Pvt ltd; 1990: 3.

Tin NL, Harris I, Hazratwala K. Retrograde nailing versus fixed-angle blade plating for supracondylar femoral fractures: a randomized controlled trial. ANZ J Surg. 2006;76:290-4.

Christodoulou A, Terzidis I, PloumisA, Metsovitis S, Koukoulidis A, Toptsis C. Supracondylar femoral fractures in elderly patients treated with the dynamic condylar screw and the retrograde intramedullary nail: a comparative study of the two methods. Arch Orthop Trauma Surg. 2005;125:73-9.

Higgins TF, Pittman G, Hines J, Bachus KN. Biomechanical analysis of distal femur fracture fixation: fixed-angle screw-plate construct versus condylar blade plate. J Orthop Trauma. 2007;21(1):43-6.

Agrawal A. Distal femur AO type A fractures – Surgical options, techniques, results and complications. Trauma Int. 2015;1(2):12-6.

Mize RD, Bucholz RW, Grogan DP. Surgical treatment of displaced, comminuted fractures of the distal end of the femur. J Bone Joint Surg Am. 1982;64:871-9.

Neer CS II, Grantham SA, Shelton ML. Supracondylar fracture of the adult femur: A study of one hundred and ten cases. J Bone Joint Surg. 1967;49:591- 613.

Schandelmaier P, Blauth M, Krettek C. Internal fixator of distal femur fractures with the less invasive stabilizing system (LISS). Orthop Traumatol. 2001;9:166–84.

Marti A, Fankhauser C, Frenk A, Cordey J, Gasser B. Biomechanical evaluation of the less invasive stabilization system for the internal fixation of distal femur fractures. J Orthop Trauma. 2001;15:482–7.

Gururaj NG, Vinaya G, Ahmad R. Comparative study between Dynamic Condylar Screw and Locking Plate Fixation in fractures of distal femur in adults – A study of 30 cases. Indian J Orthop Surg. 2016;2(2):147-50.

Chander A, Ganesan GR, Jayabalan V. Is Distal Femur Locking Plate a Superior Implant in Distal Femur Fracture? Open J Orthop. 2015;5:258-63.

Malik I, Khan R, khurana R, Sharma S. Comparative study of management of distal femoral fractures managed by dynamic condylar screw and distal femoral locking compression plate. Webmed Central Orthop. 2015;6(9):WMC004976.

Sherwing DJ, Meggitt BF. Fracture of distal femur treated with AO dynamic condylar screw. J Bone and J Surg Br. 1992;74:122-5.

Ali I, Shahabuddin. Surgical outcome of supracondylar and intercondylar fractures femur in adults treated with dynamic condylar screw. JPMI. 2011;2(1):49-55.

Schaldelmier P, Partenheimer A, Koenemamm B, Grün OA, Krettek C. Distal femoral fractures and LISS stabilization. Injury. 2001;32:55-63.

Markmiller M, Konard G, Sudkamp N. femur- LISS and Distal Femoral Nail for fixation of distal femoral fractures. Clin Orthop. 2004;426:252-7.

Jalili A, Bahrabadi M, Zare Sh. A comparison of locking versus nonlocking plates in distal femur fractures. Shafa Ortho J. 2014;1(3):17-21.