Condylar Screw Research Articles

A study to evaluate and compare the results of different modalities of operative treatment of distal femoral fracture

Aim: of the study was to evaluate and compare the results of different modalities of operative management of distal femoral fractures. Material and Method: The present study was conducted on 48 patients having fractures of the distal femur (involving distal 15cm of the femur).The cases were picked up from the patients treated at two tertiary care hospitals by open reduction and internal fixation from July 2014 to July 2018. Both anatomical and functional results were analyzed and graded. Results: Age of the patients operated upon ranged from 16-75 years (Mean age 41.6years). Male-dominated in our series, comprising 72.91% (35 out of 48 cases). All patients in our series had unilateral involvement of distal femoral fractures. The right side was however involved more i.e. 29 out of 48 (60.4%). The most common mode of the accident in our series was automobile accident (91.67%).42 out of 48 were closed fractures (87.5%), whereas the remaining 6 patients (12.5%) had open grade I type of fracture. Associated injuries were observed in 13 out of 48 cases in our series (27%). In most of the patients, the implant used was either a dynamic condylar screw or a distal femur plate. 41 out of 48 patients (85.42%) were discharged from the hospital within 7 days. Conclusion: For Distal femoral fractures early open reduction, rigid fixation allows accurate anatomical alignment, reconstruction of articular surfaces joint congruity and it offers opportunities for early post-operative knee mobilization and prevents frequent problems of limitation of knee movements, nonunion and osteoarthritis.

Avoiding iatrogenic injuries to the vertebral artery: A morphometric study of the vertebral artery-free dissection area

ObjectiveTo determine the area of a safety window that excludes the vertebral artery for the safe access of the occipital condyle screws during occipitocervical fixation. MethodsThis study included 138 cervical computed tomography angiograms. Six measurements per side were made in each imaging study. These measurements are from the vertebral artery to (A) the mastoid process, (B) the mastoid incisura, (C) the posterior condylar fossa, (D) the occipital condyle in its midline, and (E) the medial border of the condyle. We also measured from the tip of the mastoid process to the lower border of the occipital condyle on its lateral side (F). ResultsA total of 276 areas from 138 individuals were included, of which 51.4 % were men. The mean age was 54.2 ± 18.63 years. The mean variable measurements (mm) for all the population were 21 ± 4, 16 ± 3, 6 ± 2, 3 ± 2, 2 ± 1 and 35 ± 4 for variables A-F, respectively. We found significant differences between sex when we compared measurements A (p = 0.003), C (p = 0.001), D (p = 0.000) and F (p = 0.000). The incidence rate of dominance for the vertebral artery was 18.8 % and 30.4 % for right and left respectively. ConclusionWomen had significantly smaller measures than men. This could indicate a higher risk of iatrogenic injury secondary to a smaller vertebral artery-free area. Results may guide surgeons in the pre-surgical planning aiming to reduce the risk of iatrogenic injuries to the vertebral artery.

Morphometric Trajectory Analysis for Occipital Condyle Screws.

ObjectivesOccipitocervical fusion (OCF) is an effective treatment for instability of occipitocervical junction (OCJ). The occipital condyle screw serves as a novel surgical technique for occipitocervical fixation. However, the intraoperative procedures for the occipital condyle screw technique have relied on surgeons’ experience, so the pool of surgeons who are able to perform this surgery safely is limited. The present study aims to evaluate the feasibility and safety of the occipital condyle screw technique using human cadavers and to provide image anatomy for clinical application basis.MethodsThe scientific study comprised 10 fresh‐frozen cadaveric specimens from the anatomy department of Qingdao University. Placement of the occipital condyle screws (3.5 mm diameter and 20.0 mm length) was performed in the 10 fresh‐frozen cadaveric specimens with intact occipitocervical junctions, respectively. Occipitocervical CT was performed for all specimens and the DICOM data was obtained. Occipitocervical CT three‐dimensional (3D) reconstruction was performed for the cadavers. Morphometric analysis was performed on the bilateral occipitocervical junction of 10 cadaveric specimens based on the 3D reconstruction CT images. Detailed morphometric measurements of the 20 occipital condyles screws were conducted including the average length of the screw trajectory, inside and upper tilting angles of screws, distance to the hypoglossal canal, and to the medial wall of occipital condyle.ResultsPlacement of the occipital condyle screws into the 20 occipital condyles of the 10 cadaveric specimens was performed successfully and the trajectory of implantation was satisfactory according to 3D CT reconstruction images, respectively. There was no obvious injury to the spinal cord, nerve root, and vertebral artery. The length of the bilateral screw trajectory was, respectively, 20.96 ± 0.91 mm (left) and 20.59 ± 0.77 mm (right) (t = 1.306, P > 0.05). The upper tilting angle of bilateral screws was, respectively, 11.24° ± 0.74° (left) and 11.11° ± 0.64° (right) (t = 0.681, P > 0.05). The inside tilting angle of bilateral screws was, respectively, 31.00° ± 1.32° (left) and 30.85° ± 1.27° (right) (t = 0.307, P > 0.05). The screw's distance to the bilateral hypoglossal canal was, respectively, 4.84 ± 0.54 mm (left) and 4.70 ± 0.54 mm (right) (t = 0.685, P > 0.05). The screw's distance to the medial wall of the bilateral occipital condyle was, respectively, 5.13 ± 0.77 mm (left) and 5.04 ± 0.71 mm (right) (t = 0.384, P > 0.05).ConclusionThe occipital condyle screw technique can serve as a feasible and safe treatment for instability of the occipitocervical junction with meticulous preoperative planning of the screw entry point and direction based on individual differences. Morphometric trajectory analysis is also an effective way to evaluate the surgical procedure.

Efficacy of dynamic condylar screw for the treatment of distal femoral fractures: a prospective study

Introduction: The incidences of distal femoral fractures are more common in males around the age of 30 and in elderly females. Dynamic Condylar Screw is cost-effective and procedure relatively easy to perform and affords a rigid internal fixation. Materials and Methods: This prospective study was done on 56 patients aged above 18 years with distal femur fractures. The patients were operated under spinal anaesthesia. A sand bag was used under the ipsilateral hemi pelvis. Suction drain was used in all cases. Radiographs were taken on 1st POD. Change of dressing and drain removal was done on 2nd POD. Suture removal was done on 10th POD. Follow-up radiographs were taken at 6 weeks, 3 months and 6 months. Results: The predominant age group for the femoral fractures is 31-40 years (35.7%) followed by 41- 50 years 32.1%). Type A fractures were seen in 76.78% of the cases, type B in 5(8.92%) and type C in 8(14.28%) of patients. Overall results were assessed using Knee Society Score. 31(55.36%) patients had excellent results, 14(25%) had good, 9(16.07%) had fair and 2(3.57%) had poor outcomes. Conclusion: DCS remains a good implant for distal femur fractures particularly types A and B. It is easier to perform, less difficult technically and is also very satisfying to the surgeon and patients as the outcomes are very good. Keywords: Distal femoral fractures, Dynamic condylar screw, Road accidents, Osteoporosis.

Cement augmentation of an angular stable plate osteosynthesis for supracondylar femoral fractures - biomechanical investigation of a new fixation device

BackgroundImplant anchorage in highly osteoporotic bone is challenging, since it often leads to osteosynthesis failure in geriatric patients with supracondylar femoral fractures. Cementation of screws is presumed to prevent such osteosynthesis failure. This study aimed to investigate the effect of a newly designed, cementable fenestrated condylar screw for plate fixation in a biomechanical setting.MethodsEight pairs of osteoporotic cadaver femora with an average age of 77 years, ranging between 62 and 88 years, were randomly assigned to either an augmented or a non-augmented group. In both groups an instable 33-A3 fracture according to the AO / OTA classification was fixed with an angular stable locking plate. All right samples received a cement augmentation of their fenestrated condylar screws with calcium phosphate bone cement (CPC). Mechanical testing was performed at a load to failure mode by cyclic axial loading, using a servohydraulic testing machine.ResultsWith a mean of 2475 N (95% CI: 1727–3223 N), the pressure forces resulting in osteosynthesis failure were significantly higher in specimen with cemented condylar screws as compared to non-cemented samples (1875 N (95% CI: 1320–2430 N)) (p = 0.024). In both groups the deformation of the constructs, with the distal screws cutting through the condylar bone, were the most frequent cause for failure. Analysis of axial stiffness (p = 0.889) and irreversible deformity of the specimens revealed no differences between the both groups (p = 0.161). No cement leakage through the joint line or the medial cortex was observed.ConclusionBased on the present study results, the newly introduced, cementable condylar screw could be an encouraging feature for the fixation of supracondylar femoral fractures in patients with reduced bone quality in terms of load to failure accuracy of the cement application.

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A prospective study to assess the functional and radiological outcome of subtrochanteric femoral fractures using 95 degree dynamic condylar screw

Introduction: The absolute majority of the trochanteric and subtrochanteric hip fracture patients are fragile patients with a tendency to fall and an increased risk of major morbidity and mortality. It is important to provide adequate management to these patients and the treatment of choice is normally surgical with internal fixation. The surgical options for these fractures commonly include plating with sliding hip screw or intramedullary nailing, with nailing today being the predominant procedure in many parts of the world. The rationale of operative treatment of subtrochanteric fracture should be to obtain adequate reduction, achieve stability and to provide adequate fracture fixation. The final aim of treatment remains early union in anatomical position with early, active, pain free mobilization and the patient returning to his routine activitiesat the earliest. During the last century several implants have been tried to treat these fracturessurgically. The very fact that several implants have been tried proves that no one implant is found suitable in all cases. Extramedullary implants like Dynamic HipScrew and Dynamic Condylar Screw were used to fix the fracture. Dynamic Hip Screw often fails to prevent lateral drift of the proximal fragment which leads to implant failure. Dynamic Condylar screw provides better stability because of the fixation of proximal fragment with an additional screw in the calcar region, it also facilitates vertical load transmission.The dynamic condylar screw (an extra medullaryimplant) which exerts vertical forces on weight bearing is a better option as it provides strong fixation in the cancellous bone of the neck and head with considerable rotational stability. Material and Methods: We evaluated the functional outcome of subtrochanteric fractures treated with Dynamic Condylar Screw in 12 patients from October 2015 to September 2017 at Kamineni Institute of Medical Sciences in a prospective study. Results: Mean age of the patients in the was 58.9 years. Mode of injury - 75% (9) patients sustained injury due to road traffic accidents and 25% (3) patients sustained injury due to fall.66.67% (8) patients were males and 33.33% (4) patients were females. There was almost an equal distribution in regards to side of injury. Average radiological union duration was 17 weeks. Duration of follow up was 6months.8.33% (1) patient had superficial infection.8.33% (1) patient had lag screw cut through for which secondary procedure was done. Modified Harries Hip score at the end of the follow up was 58.34% (7) patients with excellent score, 33.33% (4) patients with good score and 8.33% (1) patient had poor score. Conclusion: Subtrochanteric fractures of the Femur pose a challenge to the surgeon in the view of its peculiarities of anatomy, biomechanical forces acting across the fracture site and technical difficulties of reduction and application of a suitable implant. Many implants both Intramedullary and Extramedullary have been tried by various surgeons in different time periods with varying results. In this study Dynamic Condylar Screw and plate for selected patients and results were compared with other available references. DCS is a good implant when applied in a correct manner and yields good results in terms of fracture healing with minimal complications.

COMPARATIVE STUDY OF RESULTS OF FRACTURE DISTAL THIRD FEMUR TREATED WITH VARIOUS OPERATIVE MODALITIES

Distal femoral fractures are difficult to treat and ideal treatment of such fractures will include anatomical reduction, rigid fixation of articular surfaces and early mobilization of knee joint. The purpose of the study is to evaluate the end results of surgical management of fracture of distal end of femur using various surgical modalities and analyze the complications and the causes of fractures.
 Materials and methods: A Retrospective Study of 75 patients were evaluated from tertiary hospital for a period of july 2007 to July 2009. There were 75 fractures in 75 patients involving the distal femur, which were treated surgically by internal fixation using various surgical modalities.
 Results: At the end of study, the cases were followed up for an average period of 15.6 months and functional results were evaluated using modified Schatzker and Lambert (1982) criteria. 36 cases were fixed with Supra Condylar nail ( SC nail), 20 cases were fixed with dynamic Condylar screw(DCS), 6 cases were fixed with Dynamic Compression Plate(DCP), 6 cases were fixed with Cancellous Screw, 4 cases were fixed with Enders Nail, 3 cases were fixed with Ext. Fixator
 Conclusion; Fractures of distal femur can be very effectively treated by surgical methods. The satisfactory osteosynthesis of fractures and stable osteosynthesis is achieved by the right approach and correct surgical technique.
 Keywords: distal femur fracture, internal fixation, dynamic condylar screws, supracondylar femur nail

Occipital Condyle Screw Placement in Patients with Chiari Malformation: A Radiographic Feasibility Analysis and Cadaveric Demonstration

Patients who undergo decompression surgery for Chiari malformation frequently require occipitocervical fixation. This is typically performed with occipital plates, which may cause intracranial injuries due to multiple fixation points. We undertook this study to assess the feasibility of occipital condyle (OC) screw placement as an alternative method of occipitocervical fixation in this patient population. Using a cadaveric model with navigational assistance, we performed the complete surgical procedure for occipitocervical fixation with OC screws. We then performed a morphometric analysis using measurements from computed tomography scans of 49 patients (32 adult, 17 pediatric) who had undergone occipitocervical fusion with instrumentation following decompression surgery for Chiari malformation. Bilateral morphometric data were analyzed for the adult and pediatric subgroups separately, as well as for the overall group. The surgical procedure was successfully performed in the cadaveric model, demonstrating the feasibility of the proposed method. Ninety-eight OCs were studied in the morphometric analysis, and 80 (81.6%) met our eligibility criteria for OC screw placement. However, in 14.1% of adult OCs and 26.5% of pediatric OCs studied, placement of condylar screws would have been challenging or unsafe, according to our criteria. Our findings suggest that OC screws provide a useful option for occipitocervical fixation in a substantial proportion of patients with Chiari malformation. However, rigorous preoperative analysis would be essential to identify appropriate candidates for this technique and exclude those in whom it should not be attempted. Additional study is warranted.

Occipital condyle screws: indications and technique.

Occipitocervical instability is a life threatening and disabling disorder caused by a myriad of pathologies. Restoring the anatomical integrity and stability of the occipitocervical junction (OCJ) is essential to achieve optimal clinical outcomes. Surgical stabilization of the OCJ is challenging and technically demanding. There is a paucity of options available for anchorage in the cephalad part of the construct in occipitocervical fixation systems due to the intricate topography of the craniocervical junction combined with the risk of injury to the surrounding anatomical structures. Surgical techniques and instrumentation for stabilizing the unstable OCJ have undergone several modifications over the years and have primarily depended on occipital squama-based fixations. At present, the occipital-plate-screw-rod construct is the most commonly adopted technique of stabilizing the OCJ. In certain distinct scenarios like posterior fossa craniectomy (absence of occipital squama for screw placement), malignancy and infection of occipital squama (poor screw purchase in the diseased occipital bone) and in revision surgery for failed occipitocervical stabilization, occipital plate-based instrumentation is not feasible. To overcome these difficulties, recently, a novel technique of occipitocervical stabilization, using the occipital condyle (OC) as the cephalad anchor, namely the direct occipital condyle screw (OCS) fixation was described. Several cadaveric and biomechanical studies have suggested that OCSs are feasible options as additional augmentative anchors in a standard occipital plate-screw-rod construct or as salvage cephalad anchors in previous failed occipital-plate-screw-rod constructs. The OCS placement technique has a steep learning curve. We have done a review of the techniques of OCS fixation and have described the indications, biomechanical and technical considerations, preoperative planning, surgical technique, complications, advantages and limitations of OCS based occipitocervical fixation.

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.

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.

Trochanteric femoral nonunion in patients aged over 60 years treated with dynamic condylar screw

IntroductionNonunions of trochanteric femoral fractures are uncommon due to a good blood supply of the cancellous bone of the trochanteric region. Nevertheless, if a nonunion occurs, complex revision procedures usually become necessary. The purpose of this study was to evaluate a series of aseptic trochanteric nonunions in patients aged 60 years or older, looking at outcomes regarding healing rate, implant-related complications and secondary surgeries. Material and MethodsWe conducted a retrospective chart review of patients with aseptic femoral trochanteric nonunions aged over 60 years. Nonunion treatment consisted of implant removal, debridement of the nonunion, and restoration of the neck shaft angle, followed by DCS plating. An additional 4.5-mm limited contact dynamic compression plate was placed in twelve patients anteriorly. The primary outcome measure was bony healing and time to healing in months. Secondary outcome measures included postoperative complications related to the index procedure, range of motion of the affected hip and postoperative mobility. ResultsA total of 21 patients with a mean age of 69.1 years met the inclusion criteria. After a mean follow-up of 21.62 months, 17 of the 21 nonunions healed successfully. The mean healing time was 6.59 months. A total of six of the 21 patients needed secondary revision surgery. At the final follow-up, a full range of motion of the hip was seen in 17 of the 21 hips. ConclusionsDCS treatment and preservation of the patient's femoral head can be successful for patients aged over 60 years with a well-preserved femoral head and acetabulum. However, preservation of the hip joint and revision plating might be associated with higher revision rates.

Mechanical comparison of reconstruction nail and dynamic condylar screw in the treatment of unstable Subtrochanteric fracture in vitro study

Background: Subtrochanteric femur fractures are severe injuries that are often associated with high-energy trauma in young age and a trivial fall in osteoporotic patients. These fractures constitute a major bulk of hip fractures and are difficult to treat. Objective of this study was to determine the rigidity and strength of fixation and ultimate load of failure of certain composite femur models designed to simulate unstable subtrochanteric femur fractures fixed with DCS and Reconstruction nail. Methods: Paired femora were osteotomized to produce like models of an unstable subtrochanteric femur fracture in vitro. The femora were fixed with the Reconstruction nail and a 95 degree dynamic condylar screw plate (DCS). Materials testing machine was used to apply compression to the femoral head through an adapter plate. Stiffness values were calculated from the load-deformation curves obtained. Results: The Reconstruction nail-femur model was stiffer than the 95 degree DCS. The Reconstruction nail also had the highest ultimate load-to-failure than the 95 degree DCS. Conclusion: Our findings suggest that the Reconstruction nail has greater stiffness and strength than the 95 degree dynamic condylar screw when tested in this model of an unstable subtrochanteric femur fracture.

A Study of Dynamic Condylar Screw in the Management of Subtrochanteric Fractures of Femur

A Study of Dynamic Condylar Screw in the Management of Subtrochanteric Fractures of Femur

Safe trajectory for an occipital condyle screw: A computer simulation study.

The purpose of this study was to evaluate the feasibility of posterior occipital condyle screw (OCS) placement analysis of the safe trajectory area for screw insertion. Computed tomographic angiography scans of patients (46 males and 27 females) with normal occipitocervical structures were obtained consecutively. Vertebral artery (VA)-occiput distance <4.0 mm was defined as "unfeasible" for OCS fixation, and occipital-atlas angulation was measured to assess the feasibility of screw placement. Next, the placement of 3.5 mm diameter OCS was simulated, the probability of breach of structures surrounding occipital condyles was calculated, and placement parameters were analyzed. OCS placement was feasible in 91.1% (133/146) of occipital condyles, and the feasible probability also presented a significant sex-related difference: The probability was higher for males than for females (95.7% vs. 83.3%, p < 0.05). The incidence of anatomical structures injured under screw placement limitation was 18.8% (VA), 81.2% (hypoglossal canal), 59.4% (occipital-atlas joint), and 40.6% (occiput bone surface). There were no significant differences between the left and right condyles in relation to the measured parameters (p > 0.05). The screw range of motion was significantly smaller in females than in males (p < 0.05). The feasibility of OCS placement and OCS range of motion were significantly greater in the kyphosis group (>5°) than in the other two groups (p < 0.05). OCS placement is a feasible technique for occipital-cervical fusion. The male group and occipitocervical region kyphosis group had a wider available space for OCS placement. Tangent angulation may be useful for the accurate and safe placement of an OCS.

To compare the clinicoradiological outcome of various operative techniques and fixation devices in treatment of subtrochanteric fractures

Background: There are various operative techniques and fixation devices in treatment of subtrochanteric fractures. The objective of treatment is restoration of optimal functions in the shortest possible time by the safest and most dependable method of treatment. Aim: To compare the clinicoradiological outcome of various operative techniques and fixation devices in treatment of subtrochanteric fractures and its variants. To compare the efficacy of various operative techniques in management of subtrochanteric fractures and its variants. To assess efficiency of various fixation devices in different (A-O) types of subtrochanteric fractrues and to compare our results with those available in literature. Methods: This prospective study was conducted in department of orthopedic surgery, in a span of two years. 38 Cases of subtrochanteric fractures and two types of extensions of subtrochanteric fractures admitted in orthopedics wards and treated by various operative methods were included in the study. Results: Malunion was seen in 3 cases and infection in 2 cases. Excellent and good results were seen in most of the cases fixed with intramedullary devices 35% &amp; 39% respectively) and these using closed techniques (38% &amp; 43% respectively). Majority of excellent result (52%) were seen in cases fixed with Proximal Femoral Nail. Most of the cases fixed using Dynamic Condylar Screw and Dynamic Hip Screw had fair to good results. Conclusion: Successful management of a case of subtrochanteric fracture is an exercise in balancing mechanical and biological consideration in maximize the likelihood of rapid healing and full restoration of function with minimal risk of complications at the least cost to the patient and society

Study of management of supracondylar femoral fracture using dynamic condylar screw

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Supracondylar femoral fracture poses a considerable therapeutic challenge. Operative treatment has become a standardized procedure. Stabilization has usually been achieved by an osteosynthesis with dynamic condylar screws or retrograde supracondylar nailing. In this article we are going to compare the results of surgical management of supracondylar nail and dynamic condylar screw. The aim is to study the effectiveness of dynamic condylar screw in surgical management of supracondylar fractures of femur.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Prospective study of patients who had sustained supracondylar fracture of femur. The patients included in this study were those with supracondylar fractures of the femur with or without articular involvement and disruption of the joint surface. Study was done for a period of two and half years.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In our study of 21 cases, there were 8 patients (38%) who had associated fractures. Two patients were more than 50 yrs. 3 patients had compound injury which were grade-II of Gustilo Anderson classification. One of them developed post-operative infection and resulted in poor outcome. Other 2 patients had decrease range of movements resulted in fair outcome. Type C2 constituted highest number 8 (38%) followed by type A3 which was 28.5% i.e., 8 patients. Infection is observed in 9.5% of patients. 2 patients had implant failure and both were due to early weight bearing. In our study excellent and good results were found to be in 61.9%.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Role of dynamic compression screw in the surgical management of supracondylar fractures of the femur minimizes the risk of complications.&lt;/p&gt;

Outcome analysis of subtrochanteric fractures fixed with dynamic condylar screw, dynamic hip screw and reconstruction nail

To determine the rate of union, complications, operative risks and Functional outcome in subtrochanteric fractures treated with DCS, DHS and RECONSTRUCTION NAIL. To create an algorithm for surgery of choice in various Subtrochanteric fracture patterns. To determine the complications involved in the management of Subtrochanteric fractures.

Competency of distal femur locking plate as an answer for fixation of all varieties of distal femur fractures

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Distal femur fractures are common and need to be treated operatively and for optimal functional outcome. Multiple implants are available for fixation e.g. angled blade plate, dynamic condylar screw, buttress plate, antegrade nailing, retrograde nailing, locking distal femoral plates, external fixator etc. We have designed this study to analyse clinico-radiological outcome and competency of locked plating for all varieties of distal femur fractures.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; We conducted a prospective interventional study on 79 consecutive patients with fractures of distal femur operated with locking distal femur plate from January 2015 to February 2018. Patients were regularly followed up with x-rays and clinical examination. At the end of clinicoradiological union, patients were evaluated with Neer’s score.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Total 79 distal femur fractures were studied based on inclusion and exclusion criteria. There were 63 (79.75%) males and 16 (20.25%) females. As per AO classification fracture of type A were 39 (49.36%), type B were 10 (12.65%) and type C were 30 (37.97%). Average time period from injury to surgery was 8.2 days. In our study, the average period of clinicoradiological union was 16 weeks. 62 (78.48%) patients had excellent to satisfactory outcome, 13 (16.45%) patients had unsatisfactory and 4 (5.06%) patients had poor outcome.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Distal femur fractures are common, complex injuries and different implant option are available for fixation. All types of distal femur fractures can be fixed using distal femur locking compression plate. If fixed following basic principles of fracture fixation good results can be obtained.&lt;/p&gt;