title: [DHS (Dynamic Hip Screw) osteosynthesis in an atypical situation].
abstract: The author describes a spiral fracture of the distal femur with a fragmented zone that occurred in the place of the distal end of a splint applied because of the previous treatment of a subtrochanteric fractures by osteosynthesis. Atypical approach including a DHS implant was used to treat the spiral fracture. By literature search it was found that this therapy had not previously been described. Different options for stabilization of this fracture are discussed and it is concluded that, for this indication, the use of the DHS system was the most convenient. The author sets rules for the application of a DHS implant as follows: 1) the procedure should be very fast and carried out from a small approach; 2) the fracture should be spiral or oblique and should permit compression of fragments by means of a sliding screw; 3) another non-removable implant should be present in the femur. He concludes that, if not all three criteria are met, any of the conventional methods of osteosynthesis should be used.
authors.affiliation: Klinika ortopedie a traumatologie pohybového ústrojí FN UK, Plzen.
authors.forename: J
authors.initials: J
authors.lastname: Matĕjka
mesh_terms: D000368:Aged; D001863:Bone Screws; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006620:Hip Fractures / Q000601:surgery; D006801:Humans; D016268:Internal Fixators; D011859:Radiography