The AO dynamic condylar screw for fractures of the femur.

We report our initial experience in Nottingham of use of the AO Dynamic Condylar Screw (DCS) implant system for internal fixation of fractures of the proximal and distal femur. The implant has been used in 24 cases over a 2-year period, and with an average follow-up of 1 year the results have been as favourable as those in reports of other comparable implants, but there have been a number of technical difficulties, particularly with the fixation of osteoporotic distal femoral fractures. The DCS can be used in all situations where the 95 degrees blade plate has previously been used and technically it is easier to insert correctly. We conclude that whilst the DCS may replace the corresponding blade plates in the orthopaedic surgeon's armamentarium, it does not solve the problems of fixation of osteoporotic fractures. The indications for and difficulties of such internal fixations are discussed.