Book contents
- Frontmatter
- Dedication
- Contents
- List of contributors
- Preface
- Acknowledgments
- Part I Upper extremity
- Part II Pelvis and acetabulum
- Part III Lower extremity
- Chapter 9
- Section I Extracapsular fractures of the hip
- Section II Intracapsular fractures of the hip
- Chapter 10
- Chapter 11
- Chapter 12
- Chapter 13
- Chapter 14
- Part IV Spine
- Part V Tendon injuries
- Part VI Compartments
- References
- Index
Section I - Extracapsular fractures of the hip
from Chapter 9
Published online by Cambridge University Press: 05 February 2015
- Frontmatter
- Dedication
- Contents
- List of contributors
- Preface
- Acknowledgments
- Part I Upper extremity
- Part II Pelvis and acetabulum
- Part III Lower extremity
- Chapter 9
- Section I Extracapsular fractures of the hip
- Section II Intracapsular fractures of the hip
- Chapter 10
- Chapter 11
- Chapter 12
- Chapter 13
- Chapter 14
- Part IV Spine
- Part V Tendon injuries
- Part VI Compartments
- References
- Index
Summary
DYNAMIC COMPRESSION HIP SCREW
Indications
Sliding compression hip screw devices are used to stabilize
(a) Inter-trochanteric hip fractures (Fig. 9.1a,b).
(b) Intracapsular fractured neck of femur.
Pre-operative planning
Clinical assessment
Pain localized in the affected hip site with radiation of pain to the knee.
Limb is shortened and externally rotated.
Assess and document neurovascular status of the leg.
In young patients carefulexaminationforotherinjuries must be made, as they are a result of high-energy trauma.
A complete medical examination in elderly patients.
Radiological assessment
Anteroposterior (AP) radiograph and a lateral view of the affected hip to demonstrate the fracture geometry.
Operative treatment
Anaesthesia
Regional (spinal/epidural)and/orgeneral anaesthesia.
At induction, administer prophylactic antibiotic as per local hospital protocol (e.g. 3rd generation cephalosporin).
Table and equipment
DHS instrumentation set – ensure the availability of the complete set of implants (Fig. 9.2).
A radiolucent table or a fracture table with the appropriate traction devices.
An image intensifier.
Table set up
The instrumentation is set up on the side of the operation.
Image intensifier is from the contralateral side.
Position the table diagonally across the operating room so that the operating area lies in the clean air field.
Patient positioning
Supine with awell-padded radiolucent pudendal post.
Position the uninjured leg in a leg holder (i.e. Lloyd Davies withadequatepaddingover the peroneal nerve) or in wide abduction by a footplate attached to the leg extensions of the fracture table.
A footplate attached to the other leg extension of the fracture table holds the injured leg (Fig. 9.3).
- Type
- Chapter
- Information
- Practical Procedures in Orthopaedic Trauma Surgery , pp. 151 - 157Publisher: Cambridge University PressPrint publication year: 2006