Outcome of DCS (Dynamic Condylar Screw) in failed proximal femur nails in intertrochanteric fractures: A retrospective study

Introduction: Intertrochanteric Femur fractures comprise approximately more than half of hip fractures caused by low energy mechanism seen more commonly in geriatric people, women,osteoporosis,a history of fall and gait abnormality. There are surgical managments available for this kind of fractures but still there are some failures. Above mentioned factors are responsible for failures. For that revision surgery is required. Here we are going to search outcomes of DCS in failed PFN in IT fractures. Materials and Methods: A retrospective study of 10 patients, treated with dynamic condylar screw (DCS) for implant failure after doing PFN in Intertrochanteric fracture were stastastically reviewed from march 2017 to march 2018. Observation and Results: Out of 10 cases 4 were young (<60>60years). 4 out of 4 young patients and 3 out of 6 elder patients were united properly. Nonunion was seen in 1 patient. Delayed union was seen in 1 patient and Implant failure was seen in 1 cases (10%). Restricted weight bearing status post-operatively was associated with significantly lower incidence of implant failure.Using the DCS, the results were good in the young patients with high-energy injuries. However, the implant failure rate is high in elderly patients who suffer low-energy fractures. The DCS should not be used if weight bearing cannot be minimized in this group. Conclusion: The dynamic condylar screw is a safe and reliable implant for the management of Periimplant Subtrochanteric fractures in previously operated with PFN with predictable results when principles of open reduction and internal fixation is followed as compare to other methods of fixation in developing country.