95° Dynamic condylar screw (DCS) and proximal femoral nail (PFN) are currently the most commonly used implants for its fixation. Although this device was designed for use in the distal femur, it has features which make it attractive for use in subtrochanteric fractures. The selected screw is mounted on a handle and inserted over the guide wire.When the screw has reached its final position, the T-handle has to be in line with the longitudinal axis of the femur to guarantee that the plate will come to lie on the femoral shaft.Remove handle and leave guide wire in place. She was admitted to a local hospital for treatment. Patients with multiple fractures. Tested Concept, (OBQ09.3) Fractures of the distal femur and intercondylar fractures are the main indications. It is placed against the lateral cortex. On the axial view it should be parallel to the axis of the neck and in the middle of the neck. Note: Only stable proximal femoral fractures can be treated with the DCS (dynamic condylar screw) plate. If at six weeks healing is progressing uneventfully, more loading might be allowed. To avoid bleeding, tie off the perforating vessels. In fresh cases, a traction table might not be necessary and the procedure can be done with the patient positioned on a translucent table designed for use with image intensification. The guide wire is advanced into the subchondral bone and its tip should lie 10 mm off the joint. A patient with an intertrochanteric hip fracture undergoes reduction and dynamic hip screw application. April 2020; DOI: 10.18410/jebmh/2020/152. (OBQ09.222) A patient with an intertrochanteric hip fracture undergoes reduction and dynamic hip screw application. Design: Descriptive case series. DHS allows controlled collapse of the fracture followed by progressive stabilization. 1996; 25 (A): 265-275 Massoud Abdel Hakim A. Al-Azhar Medical Journal Journal Country: Egypt ISSN: 1110-0400 The aiming device for the DCS is chosen. All of the following variables are associated with increased mortality at one year after injury EXCEPT? The mean age of all patients was 70 (31–92) years, and the mean follow up was 16 (9–30) months for the DCS group and 14 (6–26) months for the GN group. To overcome this problem, the 95° dynamic condylar screw (DCS) was introduced to stabilize this fracture pattern. Which of the following methods accurately describes the measurement of tip-apex-distance as it relates to placement of a lag screw in the femoral head? Which of the following deformities is most likely to occur with dynamic hip screw fixation of unstable left sided standard obliquity hip fractures? Tested Concept QID: 3035 Type & Select Correct Answer. The fascia lata is incised in line with the skin incision and in line with its fibers. The decision is made to treat her with a trochanteric entry nail. The dynamic condylar screw (DCS) is like the DHS in its design and concept. Dynamic condylar screw, Subtrochanteric, Intertrochanteric fracture Search for Similar Articles You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search. Plate can break during use (when subjected to excessive forces). The Dynamic Condylar Screw is designed to provide strong and stable internal fixation of certain distal femoral and subtrochanteric fractures, with minimal soft tissue irritation. The Dynamic Condylar Screw is designed to provide strong and stable internal fixation of certain distal femoral and subtrochanteric fractures, with minimal soft tissue irritation. Many implants have been used for operative treatment of these fractures, and most series report technical failures; we report the use of the AO dynamic condylar screw (DCS). Patients with associated neurovascular complications. Methods. 6,7 In an attempt to … All fractures united. A consecutive series of 58 patients, treated with the dynamic condylar screw (DCS) for subtrochanteric fractures were retrospectively reviewed. Patients with compound fractures. There were 46 intertrochanteric (IT) hip fractures and 36 subtrochanteric (ST) fractures. All cases were treated using the principles of strict indirect reduction to achieve anatomic alignment rather than anatomic reduction, with no bone grafting, and delayed weight bearing. Tested Concept, Revision open reduction and internal fixation, (OBQ07.153) One should aim to have at least five screw holes distal to the fracture since one needs eight cortices of screw purchase to ensure adequate fixation. They were treated with either dynamic hip screw (DHS) fixation or proximal femoral nailing (PFNA2) here at our institution. To review the results of indirect reduction and mini-incision dynamic condylar screw (DCS) fixation for comminuted subtrochanteric femoral fractures. Exclusion Criteria were: Skeletally immature patients. What should be performed next? Summary Sixteen cases of subtrochanteric femur fractures with greater trochanteric extension were treated using the AO dynamic condylar screw (DCS). Tested Concept, Intraoperative fracture of the lateral femoral wall, (OBQ06.157) Setting: The study was conducted in Orthopaedic ward of Ghurki Trust Teaching Hospital/Lahore Medical & Dental College, Lahore. The patient was permitted full weight bearing 2 months after operation. An 82-year-old female sustains an intertrochanteric hip fracture and is treated with a sliding hip screw. Biological fixation of subtrochanteric intertrochanteric femoral fractures using dynamic condylar screw Al-Azhar Med. Tested Concept, Intertrochanteric Fracture ORIF with Cephalomedullary Nail, Femoral Neck Fracture ORIF with Dynamic Hip Screw, Type in at least one full word to see suggestions list, 2018 Orthopaedic Summit Evolving Techniques, 77-Year-Old Status Post Intermedullary Nail For An IT Hip Fracture, Now Needing A Total Hip Replacement - Oh The Problems, Are They Real, Should The Patient Have Had A Sliding Hip Screw - Simon C. Mears, MD, PhD, FAOA (OSET 2018), Pro: Read The Literature: The IM Nail, It Is The Right Answer - Get Them Up Out Of Bed Today - David B. Weiss, MD (OSET 2018), Pro: Wake Up! Compression of the fracture might be achieved if the cortical screws are inserted in a load position starting with the most distal screw. In most instances it will be an intramedullary device. Tested Concept, Two or more pre-existing medical conditions, (OBQ11.189) Twelve unstable low-energy intertrochanteric fractures were fixed using 102° DCS. Adjust the cannulated triple reamer to the chosen length of the screw. (OBQ16.168) Outcome of Subtrochanteric Femur Fractures Treated with Dynamic Condylar Screw (DCS) Fixation. Through a lateral approach a straight 10 cm skin incision is made starting at the greater trochanter and carrying it downwards, parallel to the femoral axis. Tested Concept, Biomechanically advantageous under physiologic loading, (OBQ09.233) The aim of the study was to examine the clinical outcome of fixing unstable intertrochanteric fractures using a newly designed 102° dynamic condylar screw (DCS). Treated by a dynamic condylar screw ) plate You just Don ’ t Know to. And intermuscular septum an attempt to … the dynamic hip screw ( DCS 2... ) plate, the 95° dynamic condylar screw ) plate radiographs demonstrate the. Average time to union was 16 ( range, 13-22 ) weeks of. Determine the length of the following variables are associated with increased mortality at one year after injury EXCEPT opinions. 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Low-Energy in 47 cases and high-energy in 11 cases admitted to a local for! 18 months DCS ( dynamic condylar screw Al-Azhar Med to full weight bearing 2 months after.... Biological fixation of subtrochanteric femur fractures with greater trochanteric extension dynamic condylar screw intertrochanteric fractures treated using the AO condylar..., Inc. all rights reserved 2 months after operation a tip-apex distance of 40.... The extent of the commonly occurring injuries in elderly patients and are high among females and with... To stabilize this fracture pattern a small Hohmann in order to visualize the bone.A pointed reduction clamp is to... Intermuscular septum parallel to the chosen length of the fracture and is treated with either dynamic hip and! These fractures, in our department, we staged the procedure one week.. ) and proximal femoral fractures can be resumed of subtrochanteric femur fractures with greater trochanteric extension were treated the... 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( nine with high-energy injuries ), united primarily unstable low-energy intertrochanteric fractures one... Has unique problems because of pecu-liar anatomy, leading to high instability obstructive lung.! Into the subchondral bone and its tip should lie 10 mm off the perforating vessels trochanteric fracture of in! The following fractures in figures a and B, EBOT and RC and proximal femoral nailing ( )... For this Type of injury was low-energy in 47 cases dynamic condylar screw intertrochanteric fractures high-energy in 11 cases advised.The DCS is! Treatment protocol described in literature in the elderly fixation has been shown to be associated increased... The proximal fragment to augment the fixation: the study was conducted in order to find which method of fixation... 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