[Proximal femoral fractures. Is there an indication for the condylar screw (DCS)?]

Between 1983 and 1989 66 consecutive fractures of the proximal femur were treated with a condylar screw DCS. 42 patients were available for a follow-up study, 12 subtrochanteric fractures (mean age 58.5 years) and 30 intertrochanteric fractures (mean age 73 years). The primary union rate was clearly higher in the subtrochanteric group (10/12) compared to the intertrochanteric group (22/30). All the 8 implant complications (pull-out, metal fatigue) in the intertrochanteric group were associated with important posteromedial comminution in elderly patients who cannot be mobilized with only partial weight bearing postoperatively. Unstable intertrochanteric fractures in elderly patients should not be treated with the DCS. These are indications for the DHS which allows controlled telescoping. The indication for the DCS is limited to proximal shaft fractures in younger patients capable of partial weight bearing.