Dynamic hip screw

from Wikipedia, the free encyclopedia
Fracture with a dynamic hip screw
Dynamic hip screw

The Dynamic Hip Screw (DHS) is an orthopedic implant for the osteosynthesis of certain types of femoral neck fractures and intertrochanteric femoral fractures , which enables controlled dynamic sliding of the femoral head component along the construct. This method was introduced in the 1980s and is used very widely around the world.

There are three components of a dynamic hip screw: the screw inserted in the femoral neck and femoral head, the lateral plate and the cortex screws that fix them in the proximal femoral shaft. The idea behind dynamic compression is that the femoral head component is allowed to move along a plane. Since the bone reacts to dynamic loads, the fracture can primarily be healed .

If there is insufficient compression in the area of ​​the bone fracture and insufficiently stable contact with the medial cortex, pseudarthrosis , loosening and rupture of the DHS can occur. The position of the screw tip in the femoral head can also lead to femoral head necrosis and secondary coxarthrosis . This can make further interventions necessary. The importance of DHS compared to other osteosynthesis procedures such as the proximal femoral nail (PFN) or primary hip arthroplasty is scientifically investigated and is controversial.

Individual evidence