Subtrochanteric fractures treated with dynamic condylar screw

Abstract

Objectives: To assess the functional outcome of dynamic condylar screws to treat subtrochanteric fractures in adult patients. Methods: The prospective descriptive study was conducted at the department of orthopedic surgery, Dr. Ruth KM Pfau civil hospital Karachi, Pakistan, from March 2016 to October 2019. A total of 47 patients of 18 to 60 years of either gender with subtrochanteric fractures treated with dynamic condylar screw were included in the study. After consent and counseling, patients were operated on by a consultant orthopedic surgeon and fixed with a dynamic condylar screw. Postoperatively patients were regularly followed at 2nd, 6th, 12th, 16th, 20th weeks, and onwards monthly for at least one year. Functional outcomes such as infection, union, failure of fixation were observed in all patients. SPSS software version 23 was used to analyze data. Mean and SD was reported for numeric variables, whereas frequency and percentage were reported for categorical variables. A Chi-square test was used to assess the association between variables. Results: The mean age was estimated as 37.53±12.31 years. Most of the patients were male (74.5%), and 25.5% were females. About 27 patients had a fracture on the right side (57.4%) and 20 on the left side (42.6%). Out 47 cases, 3 were lost to follow, 33 patients showed excellent outcomes, 6 cases had a good outcome, 3 cases had fair outcomes, and 2 cases had poor functional outcomes. During the follow-up, 42 cases showed union, 3 lost to follow-up, 1 died, and 1 patient had implant break. About 2 patients had infections in post- operative duration because of fracture. Conclusion: Subtrochanteric femur fractures are challenging to operate, especially in our society where extensive trauma becomes more frequent. Dynamic condylar screws showed overall acceptable results. It is simple, locally made, readily available, and cheap, with almost the same result as other implants around proximal femur fractures.