Biological plate fixation of comminuted subtrochanteric fractures with the Dynamic Condylar Screw: a clinical study

Subtrochanteric fractures are fraught with anatomical, biological and biomechanical challenges which account for an increased incidence of nonunion and malunion. We retrospectively assessed the results achieved in 40 patients with a mean age of 36 years who were treated with biological plating using a Dynamic Condylar Screw for comminuted subtrochanteric femoral fractures between January 2004 to May 2007. Union was achieved in all cases at a mean of 15.6 weeks, with one major and 3 minor technical difficulties. There was limb length discrepancy (mean: 1 cm) in 5 cases and rotational deformity in 4 cases. Results were excellent in 45% of cases, good in 50% and fair in 5% according to Sanders' criteria. There was no statistically significant difference between the healthy and fractured sides with respect to femoral neck-shaft angles. Use of fracture table, adequate two plane fluoroscopy and adherence to technical details give predictable results with this implant available at an affordable cost, even in countries with low socio-economic status.