Dynamic screw systems without image intensifier: Early observations in eight consecutive patients

Abstract

Dynamic Screw Systems are useful in proximal and distal femoral fractures, and convey advantages over fixed angle devices. Improved proximal fragment fixation, controlled fracture impaction and a "forgiveness" with respect to axial alignment of the side plate to bone are improvements over fixed angle devices. Image intensifiers are often required to aid lag screw alignment when these devices are used. The equipments are expensive and often not available in some regions of the developing world. There is also the risk of radiation exposure to the surgical team. The burden of musculoskeletal trauma is enormous in the developing world and treatment outcomes are influenced by a host of factors. The choice of the best treatment options for patients in these resource-poor regions remains a challenge. Improvisations that aid appropriate treatment while conveying documented advantages is key to patient care in musculoskeletal disease in these regions. We document our experience in a small cohort of patients who accepted treatment of their fractures with Dynamic Screw devices in a setting without image intensifiers. Technical advances and modifications that reduce the cost of fracture care have the potential of reducing the overall cost of care in the developing world and may offer universal benefits. © 2013 Ikpeme IA.