Do dynamic condylar screw-plates lead to iatrogenic fracture?
Although many anatomic, morphologic, and radiologic studies have been carried out for the femur, as for all other bones of the skeletal system, we could not find any morphometric studies useful for orthopedic surgeons who want to understand the effects of dynamic condylar screw-plates (DCS-Plates) on the distal femur. The aim of this study was to determine the amount of cortex loss in the distal femur when inserting a DCS-Plate. Materials and methods: The lateral cortex width of 125 adult, dry, and grossly intact right and left cadaver femora was measured for the region of the femur in which the DCS-Plate was applied, and the results were analyzed statistically. Results: The mean value of the lateral cortex width (DLCW = a) of the femora was 33.5 mm (range: 44.67-24.49 mm). While inserting the DCS-Plate, 38.04% (range: 30.43%-46.09%) of the mean width of the lateral cortex was lost. Conclusion: We demonstrated the amount of lateral cortex loss in the femur while inserting a DCS-Plate. If the DCS-Plate is inserted more proximally to its original entry point, the risk of fracture at the supracondylar region increases due to the defect at the lateral cortex.
Do dynamic condylar screw-plates lead to iatrogenic fracture?
Although many anatomic, morphologic, and radiologic studies have been carried out for the femur, as for all other bones of the skeletal system, we could not find any morphometric studies useful for orthopedic surgeons who want to understand the effects of dynamic condylar screw-plates (DCS-Plates) on the distal femur. The aim of this study was to determine the amount of cortex loss in the distal femur when inserting a DCS-Plate. Materials and methods: The lateral cortex width of 125 adult, dry, and grossly intact right and left cadaver femora was measured for the region of the femur in which the DCS-Plate was applied, and the results were analyzed statistically. Results: The mean value of the lateral cortex width (DLCW = a) of the femora was 33.5 mm (range: 44.67-24.49 mm). While inserting the DCS-Plate, 38.04% (range: 30.43%-46.09%) of the mean width of the lateral cortex was lost. Conclusion: We demonstrated the amount of lateral cortex loss in the femur while inserting a DCS-Plate. If the DCS-Plate is inserted more proximally to its original entry point, the risk of fracture at the supracondylar region increases due to the defect at the lateral cortex.
___
- Dar GN, Tak SR, Kangoo KA, Halwai MA. Bridge plate osteosynthesis using dynamic condylar screw (DCS) or retrograde intramedullary supracondylar nail (RIMSN) in the treatment of distal femoral fractures: comparison of two methods in a prospective randomized study. Ulus Travma Acil Cerrahi Derg 2009; 15: 148–53. 2.
- Kao FC, Tu YK, Su JY, Hsu KY, Wu CH, Chou MC. Treatment
- of distal femoral fracture by minimally invasive percutaneous
- plate osteosynthesis: comparison between the dynamic
- condylar screw and the less invasive stabilization system. J
- Eckhoff DG, Montgomery WK, Kilcoyne RF, Stamm ER. Femoral morphometry and anterior knee pain. Clin Orthop Relat Res 1994; 302: 64–8.
- Murshed KA, Ciçekcibaşi AE, Karabacakoğlu A, Seker M, Ziylan T. Distal femur morphometry: a gender and bilateral comparative study using magnetic resonance imaging. Surg Radiol Anat 2005; 27: 108–12. 7. Li K, Langdale E, Tashman S, Harner C, Zhang X. Gender and condylar differences in distal femur morphometry clarified by automated computer analyses. J Orthop Res 2012; 30: 686–92.
- Uğurlu M, Yılmaz S, Deveci A, Ünlü S, Tunç B, Üstü Y et al. The epidemiologic characteristics of patients that underwent surgery for hip fracture. Turk J Med Sci 2012; 42: 299–305. 9. Bağış S, Adam M, Leblebici ÜB, KarataŞ M, Güven AZ, Çeliker AR. Sciatic nerve injury due to intramuscular injection: electrophysiological findings and one-year follow-up. Turk J Med Sci 2012; 42: 913–7.