To Compare the end results of Surgical Management of Supracondylar Fractures of Femur using the Dynamic Condylar Screw and Retrograde Supracondylar Nail
Journal Title: International Journal of Interdisciplinary and Multidisciplinary Studies (IJIMS) - Year 2015, Vol 3, Issue 1
Abstract
Supracondylar and intercondylar fractures of the distal femur historically have been difficult to treat. These fractures often are unstable and communicated and tend to occur in elderly or multiple injured patients. The incidence is highest in women older than 75 years and in adolescent boys and men 15 to 24 years old. Because of its proximity to knee joint, regaining full knee motion and function may be difficult. As the incidence of malunion, non union and infection are relatively high ,they continue to pose a major challenge to the orthopaedic surgeon. There are significant deforming muscle forces on the fracture fragments that make conservative treatment difficult and the mechanical demands on fracture implants are high. Previously the majority of supracondylar fractures were treated nonoperatively. During the past two decades as technology and implants have improved, the concepts of treatment of these fractures have changed significantly. Here we conducted a study to compare the end results of surgical management of supracondylar fractures of femur using the Dynamic Condylar Screw and Retrograde Supracondylar Nail. 34 patients with supracondylar / intercondylar fractures were taken into the study. Muller’s classification of supracondylar fracture of femur has been followed. Time of union, functional outcome and post operative complication were assessed amongs both modalities of treatment.The average time for radiological union in cases treated by dynamic condylar screw was 13.3 weeks and by supracondylar nail was 13.8 weeks. DCS showed excellent results in 27.8% cases, good in 38.9%, fair in 16.7% and poor in 16.7% of cases. Supracondylar nailing showed excellent result in 25% of cases, good in 33.3% fair in16.7% and poor in 25% of cases based on Schatzker and Lambert criteria. In case with DCS, Infection occurred in 1 case (3.3%) malunion in 1 case (5.6%) treated by DCS and 2 cases (16.7%) by supracondylar nail treatment. Delayed union was seen in 3 cases (16.7%) treated by DCS, in 1 case (8.3%) treated by supracondylar nail. Shortening was seen in 4 cases (22.2%) treated by DCS and in 3 cases (25%) treated by supracondylar nail. Pain was present in 3 cases treated with a supracondylar nail and in 4 cases treated with dynamic condylar screw. DCS is easier to insert, needs only two plane fixation, obtains good fixation even in osteoporotic bone and has the capacity of revising non-unions with a simple plate exchange.
Authors and Affiliations
Sandeep Wagh , Mahendra Gudhe, Sohael Khan, Mridul Arora, Gajanan Pisulkar, Vasant Gawande
Keywords
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