Minimally invasive percutaneous plate osteosynthesis with dynamic condylar screw for comminuted proximal femoral fracture.

Objective To evaluate the technique, indications and results of minimally invasive per-cutaneous plate osteosynthesis (MIPPO) with dynamic condylar screw (DCS) for the treatment of young adults unstable comminuted subtrochanteric fracture. Methods From January 2001 to January 2006, 25 patients with unstable subtrechanteric fracture were treated. There were 18 males and 7 females, with the average age of 35 years (ranged from 25 to 40 years). 20 cases suffered traffic accident injuries, and 5 cases suffered falling down injuries. According to Seinsheimer classification, 15 cases fracture were ⅢA classification, 4 cases fracture were ⅢB classification, 6 cases were ⅣV classification. All of patients were closed fracture, and underwent MIPPO with DCS. The hip joint function was evaluated according to Harris's scale after surgeries. Results All patients were followed up from 9 to 24 months, with the average of 16 months. All subtrochanteric fractures were healed and the healing time was 3--4 months, with the average of 3.5 months. No patients suffered from the complications of plate fracture, screw loosening or cutting out, delayed healing, re-fracture, hip varus deformity, and limb shortening. According to Harris's scale, there were 14 eases excellent, 8 cases were good, 3 cases were fair on the hip joint function, the excellent and good rate was 92%. Conclusion M1PPO with DCS is the credible method for the treatment of young adults unstable comminut-ed subtrochanteric fracture, which can reduce operation complications, and benefit for fracture heal and hip function recovery. Key words: Femoral fractures;  Bone screws;  Surgical procedures, minimally invasive