Comparative study between Dynamic Condylar Screw and Locking Plate Fixation in fractures of distal femur in adults-A study of 30 cases

Abstract

Background: The aim of treatment of the distal femoral fractures has been a balance between the goal of anatomical alignment and need for early function of limb. Objective: 1. To compare the rigidity of fixation achieved. 2. To compare the restoration of anatomical joint surface. Methodology: 30 patients of distal femoral fractures admitted to Department of Orthopaedics, at Government Medical College, Rajindra Hospital, Patiala. Only those cases were selected where ORIF is indicated like in patients with displaced intra-articular fractures, multiple injuries, severe ipsilateral limb injuries, displaced extra-articular supracondylar fractures, pathological fractures and most open fractures. Results: Among 30 patients, 16 cases (54%) sustained A type and 14 cases (46%) suffered type C supracondylar fracture as per AO classification. In DCS group, most (80%) of the patients had A type of fracture. In LCP group, most (75%) of the patients had C type of fractures. Bone grafting was done in 8 (24%) cases at the time of primary fixation of fractures. In DCS group bone grafting was done in two cases and in LCP group in 6 cases. In the DCS group, we had 2 cases (6%) in which only one inter fragmentary screw and 1 case in which 2 inter fragmentary screws were fixed in the distal fragment along with DCS lag screw and plate to give additional support. Conclusion: LCP is the implant of choice in comminuted fractures of distal end of femur and in elderly patients DCS can be used in distal femur fractures only when there is an uncomminuted bone stock of atleast 4 cm above the intercondylar notch. Key Words: Supracondylar, Intercondylar, Inter fragmentary screws, Bone grafting