Fratures Of The Distal Femur Treated With Dynamic Condylar Screws (DCS)

Research Background The distal femur fractures include the fracture of medial condyle and lateral condyle, fracture between condyles, and fracture of femur within 15cm. It occupies about six percent of the total femur fracture. These parts are crisp bones with wide medulla cavity. With the development of traffic transport , agriculture and industry, the distal femur fractures caused by high energy violence are tend to rise. The condition of patient is more complex and the damage degree more serious. The often seen clinical distal femur fractures are serious comminuted fracture. For their adjacent to the important blood vessel and nerve , it is complex in the surgery , easy to cause complications after the surgery, and high in the rate of disability. Because of this, the distal femur fracture is one of the hardest fractures to be treated and it's complex degree is only second to huckle fracture.Since seventies, with the improvement of surgery method and inner fixed material, the treatments of distal femur fracture are from traditional conservative treatment to positive surgical operation, and the latter obviously surpassed. Scholars from home and abroad had made a lot of researches on it. The curative effect increased with the improvement of design and material .Treatments on distal femur fracture are various at present andthey have their advantages and disadvantages.The key point of the cure lies in how to gain satisfied reset, resume normal anatomy of the arthrosis, adapt reliable and safe skill for practicing of knee joint, shortening the healing time of fractured bone, descending the rate of infection and other complications. So the trend for future distal femur fracture treatment will be the study of great reset skill with small damage, safe stuff with less reaction and treatment which is good for early practice of knee joint.Objective To discuss the clinical curative effect, speciality and the application techniques of the distal femur fracture treatment with DCS.Methods From 2001 to 2005, a total of 51 cases, 28 men and 13 women were treated with Dynamic Condylar Screws (DCS) fixation. The age is between 18 and 77 years old, and the average age is 46. According to AO/ASIF , the fractures are classified .Six cases are Al type,9 A2 type, 9 A3 type, 13 Cl type, 11 C2 type and 3 C3 type.Result X ray photographs after the operation show that 51 cases had attained anatomic reset or close, 1 case had obvious shift of fracture chips and 1 case of comminuted fracture infected chronically after the surgery and the wound was healed by clearing the wound and using the out fixed bracket. 35 Patients were 1 followed from 6 to 24 mont (average, 12 months).According to Kolment rating system, 14 cases' were graded as excellent, 14 cases good, 6 cases fair and 1 case poor.Conclusion1. Dynamic Condylar Screw has the characteristic of simple operation , accurate diaplasis and strong fixation. It helps the fractured femur move and do weight training on the early time. The concrescence rate is high. DCS can prevent the atrophy of the muscle around the knee point, arthrosclerosis and osteoporosis .So DCS is one of the ideal treatments on the distal femur fracture.2. Dynamic Condylar Screw is fit for distal femur fracture of type A, C1, and C2 ,while not applicable to serious comminuted fracture in condyle. To old patients with osteoporosis and severe comminuted fracture in coronary side, the use of DCS should be careful.3. In the clinical use of Dynamic Condylar Screw , the choose of surgery timing, injection point and condyle bolt should be noticed and infection should be prevented.