Dynamic Hip Screw (DHS)
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.
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
Who Needs This Treatment?
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The internationally validated standard for stable intertrochanteric hip fracture fixation
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Sliding mechanism converts weight-bearing forces into fracture site compression
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Allows early mobilisation within 24–48 hours — vital to elderly patient recovery
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Preserves the native hip joint — avoids replacement surgery in appropriate fracture types
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Union rates exceeding 90% in carefully selected intertrochanteric fracture patterns
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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
Dynamic Hip Screw (DHS) Cost in Hyderabad
The cost of Dynamic Hip Screw (DHS) surgery in Hyderabad generally ranges from ₹1,20,000 to ₹2,20,000, with an average estimated cost of ₹1,70,000. DHS fixation is commonly used for selected intertrochanteric hip fractures to stabilize the broken bone and support healing. The final expense depends on the fracture pattern and stability, implant selection, surgical complexity, anesthesia, diagnostic investigations, hospital stay and postoperative rehabilitation.
| Procedure | Approximate Cost Range |
|---|---|
| Intertrochanteric hip fractures | 1,20,000 2,20,000 |
The above figures are approximate estimates and the final cost may vary depending on the fracture type, patient's health and treatment requirements. The overall expense may include consultation, X-rays or other imaging, preoperative tests, surgeon and anesthesia charges, operation theatre expenses, DHS implant, hospitalization, medicines and physiotherapy. Complex or unstable fractures, associated injuries or complications may require additional treatment and increase the total cost.
Factors Affecting the Cost of Dynamic Hip Screw Surgery
The cost of DHS surgery depends on the fracture's location and stability, the implant and fixation method required, surgical complexity and the patient's overall medical condition. Diagnostic tests, anesthesia, hospitalization and rehabilitation can also affect the final treatment expense.
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Fracture pattern: The location, displacement and stability of the intertrochanteric fracture influence the surgical plan.
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Bone quality: Osteoporosis or reduced bone strength may affect fixation planning and postoperative care.
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Implant selection: The DHS plate, screw and related implant specifications can influence the cost.
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Surgical complexity: Difficult fracture patterns may require additional operative time or specialized surgical resources.
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Diagnostic investigations: X-rays and, in selected cases, CT scans and blood tests may be needed before surgery.
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Anesthesia: Anesthesia requirements and procedure duration can affect the overall expense.
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Hospital stay: Admission duration and postoperative monitoring may vary according to the patient's condition.
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Associated injuries: Other fractures or trauma-related injuries may require additional evaluation and treatment.
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Patient's general health: Existing medical conditions may require preoperative optimization or additional monitoring.
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Rehabilitation: Physiotherapy, mobility training and follow-up appointments may contribute to the overall cost.
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Complications or additional procedures: Any unexpected treatment needs may increase the final hospital bill.
Insurance Coverage for Dynamic Hip Screw Surgery
DHS surgery for a medically necessary hip fracture may be covered by health insurance, subject to the terms and conditions of the individual policy. Coverage can vary depending on implant limits, hospitalization benefits, exclusions, waiting periods and pre-authorization requirements. Patients or caregivers should confirm the applicable benefits and approval process with the insurer.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Sai Kishan
Orthopaedic & Joint Replacement Surgeon
Dr. Sai Kishan Sirasala is a Consultant Orthopaedic Surgeon at Lux Hospitals, Hyderabad, with expertise in orthopedic surgical care, arthroscopy, sports medicine and joint replacement. Patients with intertrochanteric hip fractures can consult him for fracture assessment and treatment planning, including evaluation of whether DHS fixation or another approach is suitable. During the consultation, the doctor may assess: How and when the injury occurred Fracture location, displacement and stability X-ray or CT scan findings when required Bone quality and general health Associated injuries and medical conditions Whether DHS fixation is appropriate for the fracture pattern Alternative fixation or treatment options, if indicated Expected recovery, mobility and weight-bearing guidance Rehabilitation needs and follow-up schedule The treatment plan is tailored to the fracture characteristics, the patient's health and the expected functional recovery.
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