DHS with TSP

2. • 78-year-old, female patient, known case of
hypertension, osteoporosis, osteoarthritis
both knees and dyslipidemia; came to AKUH
emergency department with the presenting
complaint of ground level fall.
• She was unable to weight bear on left lower
limb after that

3. On Examination
• Vitaly stable
• GCS: 15/15
• Shortened and externally rotated left lower
limb
• No wound, bruises and abrasions noted
• Distal neurovascular intact

6. AO classification

7. Evans-jansen classification
1B1A 2B 3

8. Position :
Supine with traction
table
Reduction:
traction, abduction
and internal
rotation

9. Approach :
Lateral
Incision:
a straight lateral skin incision of
approximately
15 cm in length, starting two
finger-widths proximal to
the tip of the greater
trochanter
Internervous Plane :
There is no internervous or
intermuscular plane,
because the dissection splits
the vastus lateralis muscle,
which is supplied by the
femoral nerve.

24. Post op
Day 0: complete bed rest
Day 1: Non weight bearing bed to chair
Day 2: partial weight bearing with walker