Early Outcome of Distal Femur Fracture Fixation in Adults: A Comparative Study Between Dynamic Condylar Screw and...

Distal femoral fractures are difficult to treat due to their proximity to the knee joint, and different modalities have been developed over the years to overcome these challenges. Some studies have shown variable results of different operative modalities. However, there is little evidence to show the superiority of one over the other.

To compare the functional outcome of operative treatment between dynamic condylar screw (DCS) with a side plate and distal femoral locked compression plate (DFLCP) using the Schatzker and Lambert criteria. The mean time to union and complications were secondary outcome measures.

This prospective study was carried out in our hospital between January 2018 and December 2019. Eighty-seven patients with closed distal femur fractures arbeitsgemeinschaft für osteosynthesefragen (AO) typesA, B1, B2, C1, and C2 were consecutively recruited into DCS and DFLCP groups using a simple balloting technique. The outcome measures were compared between the groups at six weeks, six months, and one year durations.

A total of 82 patients completed the study. According to the Schatzkers and Lambert criteria at final follow-up, six (15%) patients had excellent results, 24 (60%) had good results, and 10 (25%) had moderate results in the DCS group. In the DFLCP group, eight (19%) had excellent results, 26 (62%) had good results, and eight (19%) had moderate results. There was no significant difference in the functional outcome between the groups (P = 0.385). The mean time to union was 14.3 weeks and 13.9 weeks in the DCS and DFLCP groups, respectively, with no significant difference (P = 0.53). Similar complications, like surgical site infection, limb length discrepancy (LLD), varus deformity, and stiff knee, were observed in both groups.

The functional outcome, time to union, and complication rates were similar in both DCS and DFLCP groups. Emphasis should be laid on surgical principles such as soft tissue handling, good reduction, fixation techniques, and early rehabilitation.