Comparison of Retrograde Femoral Interlocking Nail Versus Dynamic Condylar Screw in Distal Femoral Shaft Fractures

Objective: The aim of this study is to compare the effectiveness of retrograde femoral interlocking nail versus dynamic condylar screw in distal femoral shaft fractures. Study Design: Prospective/Randomized comprehensive Place and Duration: Department of Orthopaedic Surgery Bahawal Victoria Hospital (BVH) / QAMC, Bahawalpur for duration of eight months i.e July 2020 to February 2021. Methods: Total 65 patients of both genders were presented in this study with age ranges between 20-40 years. Patients detailed demographics age, sex and BMI were calculated after taking informed written consent. Patients were divided into 2- groups, I and II Group I had 32 patients and underwent for retrograde femoral interlocking nail and group II had 33 patients and received dynamic condylar screw. Mean operative time, mean union time of bones and complications were calculated. Effectiveness among both groups was calculated by HSS score. Complete data was analyzed by SPSS 22.0 version. Results: Most of the patients were males 40 (61.54%) and 25 (38.46%) were females. Mean age of the patients in group I was 26.46±4.28 years and in group II mean age was 30.78±8.22 years. Mean operative time in group I was 82.8±7.14 minutes while in group II it was 90.6±8.19 minutes. Mean union time in group I was 22.7±2.5 weeks and in group II was 26.21±5.3 weeks. According to HSS score in group I 16 (50%) results were excellent, 11 (34.38%) was good, 3 (9.8%) showed moderate and 2 (6.25%) was poor, while in group II excellent results were 15 (45.45%), 10 (30.30%) was good, 5 (15.15%) showed moderate and 3 (9.09%) showed poor results. Complications were observed joint stiffness, delayed union, non union and varus deformity were significantly lower in group I as compared to group II. Conclusion: We concluded in this comparison of study that bothretrograde femoral interlocking nail and dynamic condylar screw was useful and effective methods for trauma in distal femoral shaft fractures. But less union time and good outcomes were observed in interlocking nail as compared to dynamic condylar screw. Keywords: Distal femoral shaft fractures, Trauma, Dynamic condylar, Interlocking nail

Outcome of Dynamic Condylar Screw with Plate versus Distal Femoral Lock Compression Plate Fixation in Fracture of Distal Femur

Introduction: The dynamic compression screw with plate implant used to treat fractures of the distal femur. The distal femoral lock compression plate fixation is designed as an alternative surgical option to treat these fractures. The objective of this study was to assess the comparative endurance of both devices. The objective of the study is to compare the outcome of DF-LCP and DCS fixation in distal femoral fractures. Materials and Methods: This prospective comparative study was conducted in the Department of Orthopaedics, Sylhet MAG Osmani Medical College Hospital, Sylhet between January 2011 and December 2012. Thirty patients with AO type 33-B and 33-C fracture were selected and were divided randomly into group-A and group-B by odd and even number. Dynamic condylar screw (DCS) fixation was used in group-A and distal femoral locking compression plate (DF-LCP) fixation in group-B. Results: DCS group [9 male, 6 female; mean age, 44.9 ± 12.9 years] and DF-LCP group [10 male, 5 female; mean age, 42.6 ± 15.7) years] were similar in age (p=0.660) and sex (p=0.705). The total operation (minutes) [92.3 ± 7.5 versus 90.4 ± 6.9; p=0.484], length of postoperative hospital stay (days) [6.0 ± 0.9 versus 5.9 ± 0.9; p=0.695] and union time (weeks) [20.6 ± 5.0 versus 18.7 ±3.3 weeks; p=0.238] did not differ significantly between two groups. Total complications [6 (40.0%) versus 4 (26.7%); p=0.439] was also similar in both groups. Functional outcome was excellent in 13.3%, good in 33.3%, fair in 33.3% and poor in 20.0% cases in DCS group; while excellent in 53.3%, good in 20.0% fair in 6.7% and poor in 20.0% of cases in DF-LCP group; different was not significant (p=0.080). Conclusion: Dynamic condylar screw with plate and distal femoral locking compression plate fixation are equally effective for achieving satisfactory union and functional outcome in AO type 33-B, 33-C fracture distal femur. Medicine Today 2021 Vol.33(1): 45-49

COMPARISON OF FUNCTIONAL OUTCOME OF DYNAMIC CONDYLAR SCREW AND CONDYLAR BLADE PLATE IN TYPE A FRACTURES OF DISTAL FEMUR IN SKELETALLY MATURUE PATIENTS

ABSTRACT BACKGROUND & OBJECTIVE: Distal femur fractures are increasingly common injuries in today’s orthopedic practice. Early treatment with suitable implant brings in promising functional outcomes. There is a growing debate over the type of implant used in these injuries. Therefore, we have compared two commonly used implants to determine the functional outcomes in search of an implant that has less post op complications, less technically demanding and produces better results. To compare the functional outcome of dynamic condylar screw with condylar blade plate in treatment of distal femur fractures. METHODOLOGY: A total of 372 skeletally mature patients aging 18-60 years of both gender with fracture distal femur (Type A, according to OTA classification) presented within 3 weeks of fracture time were included. Patients meeting inclusion criteria were stratified into two groups having 186 patients each. Group A and Group B. Group A received dynamic condylar screw fixation and in group B, condylar blade plate fixation was preferred. Patients were followed for 3 years and their Functional outcome was evaluated with the help of Lysholm Knee Score. RESULTS: Lysholm knee score after 3 years in group A (Dynamic condylar screw) was excellent (95-100) in 173 patients (76.9%), Good in 33 (17.7 %), Fair in 8 (4.3%), poor in 2 (1.1%).However, group B had Excellent in 57(30.6%), Good in 59(31.7%), Fair in 38 (20.4%), and poor in 32 (17.2%). CONCLUSION: Dynamic condylar screw can be used as an effective treatment with better functional outcome as compared to condylar blade plate in type A fractures of distal femur.

COMPARATIVE STUDY OF INTERNAL FIXATION OF DISTAL FEMORAL FRACTURES IN ADULTS USING DYNAMIC CONDYLAR SCREW AND DISTAL FEMORAL NAIL

Background: Distal femoral fractures are uncommon, usually complex and account for about 7% of all femoral fractures. These fractures often are unstable and comminuted and tend to occur in elderly or multiply injured patients. The incidence is highest in women older than 75 years and in adolescent boys and men 15-24 years. Aim: To compare the results of different modes of internal fixation of different type of distal femur fractures by Distal Femoral Nail and Dynamic Condylar Screw. Materials and Methods: The study was conducted in the department of orthopedics, R.G. Kar Medical College & Hospital; 1,K.B. Sarani, Kolkata – 700004. The main source of patients was those adults presenting with distal femoral fractures attending either emergency or outdoor & also patients referred from peripheral hospitals. Distal femoral fractures of AO/OTA type A fractures (i.e. extra-articular supracondylar) & AO/OTA type C1 & C2 fractures (i.e. articular simple, metaphyseal simple type & articular simple & metaphyseal multifragmentary type respectively). Results: Most of the patients were operated on an average of 6.5th day from injury. Average intra-operative blood loss and operating time for DFN were significantly low compared to the other group. The average duration of hospital stay was 14.7 days overall. No groups showed significant higher duration of the same. Conclusion: Dynamic condylar Screws give results in treating pure supracondylar or complete intraarticular fractures, although with less satisfactory outcomes especially in the latter.

Functional outcome of Subtrochanteric Fractures of femur fixed with Dynamic Condylar Screw (DCS).

Objectives: To determine functional outcome of Subtrochanteric femur fractures fixed with dynamic condylar screw. Study Design: Single group quasi experimental study. Setting: Orthopedic Surgery, creek general hospital, united medical and dental college and KVSS SITE hospital Karachi. Period: 15th February 2015 to 30th November 2016. Material & Methods: All the patients with Type 32A (A1, A2 and A3) subtrochanteric fractures of femur presenting within two weeks of injury were included in the study. Functional outcome was assessed by modified Schatzker and Lambert Criteria. Results: 79 patients with closed subtrochanteric fractures were included in study. The mean age of the patients was 41.2±12.98 years, mean duration of fracture was 4.58±1.25 days. Male to female ratio was 2.04 to 1, 42(53.16%) were injured in road traffic accident and 37(46.84%) were due to fall, right side were effected in 40.51% cases and left side effected in 59.49% cases. Acceptable functional outcome achieved in 82.28% (65/79) of cases. Conclusion: We conclude that open reduction and internal fixation are the best procedure to treat difficult fractures like subtrochanteric fractures and to avoid complications like implant failure, nonunion, and mal-union. In our study we attained satisfactory results by the use of dynamic condylar screw in patients with subtrochanteric fracture of femur.