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Dynamic hip screw: does side make a difference? Effects of clockwise torque on right and left DHS
R Mohan1, R Karthikeyan, S V Sonanis
1Department of Orthopaedics, Airedale General Hospital, Steeton, Keighley BD20 6TD, W. Yorks, UK.
Injury
|November 21, 2000
Summary
Clockwise torque during Dynamic Hip Screw (DHS) fixation can cause unstable fractures in the left hip, leading to an anterior spike. Reducing torque during DHS procedures is recommended for left-sided unstable hip fractures.
Area of Science:
- Orthopedic surgery
- Trauma surgery
- Biomechanics
Background:
- Unstable intertrochanteric fractures require stable fixation.
- Dynamic Hip Screw (DHS) is a common fixation device.
- Potential for rotational torque during screw insertion exists.
Purpose of the Study:
- To assess the impact of clockwise rotational torque on fracture configuration.
- To compare the effect of torque on left-sided versus right-sided DHS fixations.
- To investigate the development of anterior spikes in unstable intertrochanteric fractures.
Main Methods:
- Retrospective analysis of unstable intertrochanteric fractures treated with DHS.
- Evaluation of fracture configuration, specifically anterior spike formation.
- Comparison between left-sided and right-sided DHS fixations.
Main Results:
- Anterior spikes were observed in 11 out of 30 left-sided unstable fractures.
- No anterior spikes were noted in 26 right-sided unstable fractures.
- A statistically significant difference (p<0.001) in anterior spike formation between left and right sides was found.
Conclusions:
- Clockwise rotational torque during DHS insertion can lead to unstable fixation constructs.
- Left-sided DHS fixations are more susceptible to developing anterior spikes.
- Modifying torque application is suggested for treating left-sided unstable intertrochanteric fractures.