Effectiveness of Dynamic Condylar Screw (DCS) in Treating Unstable Proximal Femoral Fractures

Despite the availability of various treatment modalities for proximal femoral fractures, there remains ongoing debate regarding the optimal fixation method especially those for unstable fractures, particularly in patients with resource-limited areas. Objective: To assess the effectiveness of dynamic condylar screw fixation in treating unstable proximal femoral fractures. Methods: A longitudinal prospective study was conducted from Nov 2021 to Dec 2022. 47 patients aged between 18 to 65 years with unstable proximal femoral fractures (intertrochanteric, sub-trochanteric, or complex fractures involving the femoral neck or shaft), were included in the study and followed up for 1 year. Patients with open fractures, poly-trauma, and ipsilateral hip surgery were excluded from the study. The effectiveness of the dynamic condylar screw in treating unstable proximal femoral fractures was measured through a structured clinical and radiographic follow-up process. Patients underwent open reduction and internal fixation using a 95° DCS to ensure optimal fracture stabilization. Results: The study involved 47 patients with intertrochanteric (42.6%), sub-trochanteric (31.9%), and complex fractures (25.5%). The effectiveness of treatment and postoperative outcomes was reported in 43 patients (91.5%), with unsuccessful outcomes in 4 (8.5%). The acceptable alignment as per the radiological evidence was seen in 38 patients (80.9%), mal-unions were observed in 5 (10.6%), and implant failure in 4 (8.5%). Functional outcomes showed 29.8% excellent, 44.7% good, 17.0% fair, and 8.5% poor results. Conclusions: it was concluded that the study demonstrated a high rate of successful treatment across different fracture types, with no significant differences in success rates.