创伤与治疗杂志

Management of Comminuted Subtrochanteric Femur Fractures by Indirect Reduction and Biological Fixation with Dynamic Condylar Screw

Abstract

Mohamed Mansour Elzohairy

Background: The Comminuted subtrochanteric femoral fractures are considered as one of the most difficult fractures to treat in the orthopaedic literatures. The aim of this prospective study was to evaluate the indirect reduction and biological fixation technique with Dynamic condylar screw and plate fixation for the treatment of comminuted subtrochanteric femoral fractures.

Method: Thirty one cases suffered from comminuted subtrochanteric fractures femur, AO classification (type C), were treated by biological fixation, indirect reduction method with Dynamic condylar screw and plate fixation.

Results: The cases were followed up by clinical and radiological examination from 12 to 32 months (mean 22 months). In all cases union in acceptable alignment were achieved from 15 to 24 weeks (range from 3 to 6 months) (mean 4.5 months) in all cases except, three cases (9.7%) with failures of the fixations due to osteoporosis and early full weight bearing one week after surgery. With exception of 3 cases with fixation failures who excluded from the analysis of the functional results, all the cases had good functional outcome as regarding to Harris hip score which varying from 70 to 95 (mean 85).

Conclusion: Indirect reduction and biological fixation with Dynamic condylar screw and plate fixation is considered as a valuable cheap fixation method for the management of comminuted subtrochanteric fractures femur especially in young patients’ populations.