DHS principles Biomechanics presentation.pdf
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This document discusses the treatment of intertrochanteric hip fractures. It notes that fracture patterns like posteromedial comminution or subtrochanteric extension may require devices like cephalomedullary nails or fixed angle screws instead of a dynamic hip screw. It emphasizes the importance of pre-operative planning to determine the best method for reducing the fracture and achieving a target tip-apex distance of less than 25mm when implanting cephalomedullary devices.
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- 2. *
- 5. * *Posteromedial comminution (calcar) *Subtrochanteric extension / reverse oblique *Involvement of lateral cortex
- 6. * *Dynamic hip screw (DHS) *Cephalomedullary device *Fixed angle device
- 7. *
- 8. *
- 10. *
- 14. * Shorter lever arm in CMD – reduce bending forces
- 15. *
- 16. * *Pre-op planning to determine best way to reduce the fracture *Traction *Internal rotation *Occasionally need to lift the posterior displacement
- 20. *
- 22. * *Correct indication *Pre-op planning *Reduce before scrub *Slightly inferior - centre *Achieve TAD <25mm