Do dynamic condylar screw-plates lead to iatrogenic fracture?

Authors: MAHMUT NEDİM AYTEKİN, FATİH KÜÇÜKDURMAZ, İSMAİL ÇELİK, ALİ FIRAT ESMER, FUAT AKPINAR

Abstract: 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 = \alpha) 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.

Keywords: DCS-Plate, iatrogenic fracture, lateral cortex

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