Dynamic hip screw - implant failure

Case contributed by Dr Maulik S Patel

Presentation

Status post hip surgery, persistent pain.

Implant failure on the right with malunion of the non-ossified fracture. Normal dynamic hip screw on the left. 

Case Discussion

Normal post-op dynamic hip screw (DHS) appearance:

  • the lag screw should be in the center of the femoral head
  • the tip of the lag screw should be ~0.5 inches away from the femoral head articular surface
  • side-plate closely abutting lateral femoral cortex without any gap
  • screws for plate fixation should just penetrate the medial femoral cortex

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