The dynamic condylar screw and barrel plate as an angle guide for summation wire placement in supracondylar fractures of the femur

The dynamic condylar screw device with a fixed angle barrel plate (958) can be used for extraarticular or intraarticular fractures of the distal end of the femur. It is important that a minimum of 4 cm of bone be present in the lateral femoral condyle for the application of this technique. Even though the dynamic condylar screw allows freedom of movement in the saggital plane compared to the condylar blade plate, the complications of malposition are common. The summation technique where alignment K wires are placed, is often quite challenging to apply correctly. The summation guide wire acts as a guide for the metaphyseal component of the device and determines the ultimate placement of the side plate. To facilitate placement of this summation wire, most surgeons use commercially available angle guides. Our experience shows that the slightest variation between the angle guide and the angle of the barrel plate often causes malplacement of the screw. This discrepancy is quite common in the instrumentation available to the third world