Treatment of subtrochanteric femur fractures using the dynamic condylar screw.

Thirty-two consecutive subtrochanteric femur fractures were treated using the 95 degree dynamic condylar screw between 1982 and 1985. All fractures were classified according to the radiographic criteria of Seinsheimer. Twenty-two patients were available for follow-up study, with an average time of 23.8 months. Functional results were rated using a new traumatic hip score rating system. The overall union rate was 77.3% (17/22), with functional results rated as excellent or good in 68% (15/22). All five technical failures were associated with extensive bony comminution. Four of these failures were not bone grafted. There were no cases of screw penetration of the femoral head or neck. The indications for the use of this device include transverse, short, and long oblique subtrochanteric fractures, with or without lesser trochanteric avulsion. When excessive comminution exists, this device should not be employed.