✦ Hip Fracture Fixation

Dynamic Hip Screw (DHS)

Q: Which hip fracture types are treated with a DHS?

The DHS is used for intertrochanteric fractures — those in the trochanteric region between the femoral neck and shaft. Femoral neck fractures are treated differently, with cannulated screws in undisplaced fractures or hemiarthroplasty in displaced fractures in elderly patients.

Q: How soon after DHS surgery can I start walking?

Supervised mobilisation with a walking frame begins within 24–48 hours in most patients. The sliding mechanism allows controlled weight-bearing that promotes healing. Most patients achieve independent walking at 8–12 weeks following consistent physiotherapy.

Q: Does the DHS plate need to come out after the fracture heals?

The DHS plate and screw are left permanently in the majority of patients. Removal is occasionally performed if the hardware causes localised discomfort or prominence after the fracture has fully consolidated — typically not before 12–18 months post-surgery.

Q: How is the DHS different from an intramedullary hip nail?

The DHS is an extramedullary device — the plate sits outside the femoral shaft. A proximal femoral nail sits inside the canal. Both achieve sliding compression. IM nails are preferred for unstable and reverse-oblique patterns; DHS for stable and moderately unstable fractures.

A sliding lag screw and side plate construct stabilises intertrochanteric hip fractures — allowing controlled fracture compression under weight-bearing and providing a reliable path to early mobilisation and predictable healing.

45–75 min PROCEDURE

3–5 Days HOSPITAL STAY

>90% SUCCESS RATE

8–12 Weeks FULL RECOVERY

What is Dynamic Hip Screw (DHS)?

The Dynamic Hip Screw is the established surgical standard for intertrochanteric femoral fractures — those occurring in the region between the femoral neck and the femoral shaft. A large lag screw is inserted through the femoral neck into the femoral head, connected to a barrel-and-plate assembly along the lateral femoral shaft. The screw slides within the barrel as the patient loads the limb, allowing controlled fracture site collapse that promotes healing under compression rather than distracting the fragments apart. Dr. Sai Kishan performs DHS fixation at Lux Hospitals under AO Trauma principles — an internationally standardised approach to hip fracture management.

Appropriate for stable and moderately unstable intertrochanteric femoral fractures in patients of all ages — where the fracture geometry is amenable to sliding screw fixation, the femoral head retains an intact blood supply, and internal fixation is clinically preferable to joint replacement.

How the Procedure Works

Anaesthesia & Traction Table Positioning

Spinal or general anaesthesia; the patient is positioned on a traction table with the fracture reduced and maintained under continuous fluoroscopy.

Guide Wire Placement

A guide wire is advanced carefully into the centre of the femoral head — position in the inferior-central zone is confirmed in both AP and lateral fluoroscopic views.

Reaming & Lag Screw Insertion

The femoral neck is reamed over the guide wire; the appropriately measured DHS lag screw is inserted to the correct depth within the femoral head.

Side Plate Fixation

The side plate is slid over the screw barrel and applied to the lateral femoral cortex; cortical screws are placed through the plate holes to fix it securely to the shaft.

Wound Closure & Mobilisation

The wound is closed in layers; supervised weight-bearing with a frame begins within 24–48 hours of surgery.

Outcomes

45–75 minDURATION

3–5 DaysHOSPITAL STAY

>90%SUCCESS RATE

8–12 WeeksFULL RECOVERY

Who Needs This Treatment?

→The internationally validated standard for stable intertrochanteric hip fracture fixation
→Sliding mechanism converts weight-bearing forces into fracture site compression
→Allows early mobilisation within 24–48 hours — vital to elderly patient recovery
→Preserves the native hip joint — avoids replacement surgery in appropriate fracture types
→Union rates exceeding 90% in carefully selected intertrochanteric fracture patterns
→Relatively short operative time reduces anaesthetic exposure in frail patients

The DHS has been treating hip fractures effectively for decades — and its continued widespread use reflects something important: it works. Getting the elderly patient on their feet the morning after surgery is exactly what this implant is designed to achieve.

— — Dr. Sai Kishan Sirasala, Knee and Hip Joint Replacement & Robotic Surgery

Common Questions

Frequently Asked

Which hip fracture types are treated with a DHS?+

How soon after DHS surgery can I start walking?+

Does the DHS plate need to come out after the fracture heals?+

How is the DHS different from an intramedullary hip nail?+

Not sure which treatment is right for you?

Book a consultation with Dr. Sai Kishan and get a personalised treatment plan.

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