Dynamic Hip Screw (DHS) Procedure
A sliding lag screw and side plate system for intertrochanteric hip fractures — allowing controlled fracture collapse along the screw axis, promoting reliable union while enabling early weight-bearing.
What is Dynamic Hip Screw (DHS) Procedure?
The Dynamic Hip Screw (DHS) is a sliding lag screw and barrel-plate system that is the most widely used implant for stable and selected unstable intertrochanteric hip fractures. The large lag screw is inserted across the femoral neck into the femoral head and connected to a side plate fixed to the lateral femur. The key mechanical principle is the sliding mechanism — the screw is able to move within the barrel, allowing the fracture to impact and compress under body weight, promoting rapid and reliable union. DHS fixation allows full weight-bearing within 24–48 hours, which is critical in elderly patients to prevent the serious complications of immobility — chest infections, blood clots, pressure sores, and rapid physical deconditioning.
Suitable for stable and most unstable intertrochanteric (pertrochanteric) hip fractures in adults of all ages. The DHS is most effective for fractures where the posteromedial cortex is intact (Evans Type I), providing a stable fulcrum for the sliding screw mechanism.
How the Procedure Works
Fracture Reduction
Patient positioned on a traction table; the fracture is reduced under fluoroscopic guidance without opening the fracture site.
Guidewire Placement
A guidewire is inserted percutaneously through the lateral femur, across the fracture, and into the central axis of the femoral head.
Lag Screw Insertion
The lag screw is drilled over the guidewire and positioned centrally in the femoral head — the tip-apex distance is minimised to prevent cut-out.
Side Plate Fixation
The side plate is applied to the lateral femur and secured with cortical screws, connecting the lag screw to the shaft.
Early Mobilisation
Full or partial weight-bearing commences 24–48 hours post-surgery with physiotherapy guidance.
Outcomes
Who Needs This Treatment?
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Allows immediate or very early full weight-bearing — critical in elderly patients
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Sliding mechanism promotes controlled fracture impaction and faster union
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Well-established procedure with decades of reliable clinical evidence
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Implant removal generally not required once union is confirmed
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Low infection risk with minimally invasive technique
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Quick procedure time minimises anaesthetic risk in frail patients
"In an elderly patient with a hip fracture, getting them weight-bearing within 24 hours is not just about comfort — it is a matter of survival. The dynamic hip screw achieves that reliably, and for appropriate fracture patterns, it remains the best tool available."
— Dr. Satish Reddy Gandavarapu, Senior Orthopaedic Consultant and Trauma Surgeon , Lux Hospitals, Hyderabad
Dynamic Hip Screw (DHS) Cost in Hyderabad
The cost of Dynamic Hip Screw (DHS) surgery in Hyderabad generally ranges from ₹1,20,000 to ₹2,20,000, with an indicative average cost of around ₹1,70,000. Dynamic Hip Screw fixation is used for selected fractures around the upper part of the femur, particularly certain intertrochanteric and related hip fractures. The final cost depends on the fracture pattern, implant selection, surgical complexity, anaesthesia, hospital stay and postoperative care.
| Procedure | Approximate Cost Range |
|---|---|
| Dynamic Hip Screw (DHS) | ₹1,20,000 – ₹2,20,000 |
The above range is indicative; the final package and inclusions should be confirmed with the hospital before publication. The actual cost may vary depending on the fracture location and pattern, implant requirements, surgical complexity and additional treatment needs.
Factors Affecting the Cost of Dynamic Hip Screw (DHS) Surgery
The overall cost of Dynamic Hip Screw fixation can vary depending on the type and complexity of the hip fracture, implant selection, reduction requirements, anaesthesia, hospitalisation and postoperative rehabilitation.
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Fracture type and complexity: The location, displacement, stability and pattern of the hip fracture can influence the difficulty of reduction and fixation.
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Implant selection: The size and type of DHS implant, including the sliding hip screw, side plate and associated fixation components, can affect the overall procedure cost.
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Bone quality: Reduced bone density or significant bone weakness may influence fixation planning and the choice of implants or additional stabilisation techniques.
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Surgical complexity: Difficult fracture reduction, associated fractures or challenging anatomy may require additional operative time and specialised surgical techniques.
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Preoperative investigations: X-rays, blood tests, ECG and other investigations may be required before surgery. These may be billed separately when not included in the hospital package.
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Anaesthesia and hospital charges: Operating-room charges, anaesthesia, medicines, nursing care, room charges and hospitalisation may contribute to the final package depending on the hospital's billing structure.
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Postoperative rehabilitation: Recovery may involve physiotherapy, assisted mobilisation, walking support and follow-up imaging. These services and related expenses may be separate from the surgical package.
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Additional procedures: If the fracture requires another fixation method, treatment of associated injuries or further surgery during recovery, the overall treatment cost may increase.
Insurance Coverage for Dynamic Hip Screw (DHS) Surgery
Dynamic Hip Screw surgery may be covered by health insurance when medically necessary for fracture treatment, subject to the patient's policy terms, exclusions, waiting periods, insurer approval and hospital coverage arrangements. Patients should confirm pre-authorisation requirements, implant coverage and applicable deductibles with their insurer before treatment.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Satish Reddy Gandavarapu
Orthopaedic & Joint Replacement Surgeon
Dr. Satish Reddy at Lux Hospitals, Hyderabad, can evaluate patients with hip and upper femur fractures and determine whether Dynamic Hip Screw fixation is appropriate based on the fracture pattern, bone condition, imaging findings and overall health status. During the consultation, the doctor may assess: Injury history: The doctor may review how the injury occurred, when it happened and symptoms such as hip pain, swelling, difficulty standing or inability to bear weight. Fracture characteristics: The location, displacement, stability and pattern of the fracture may be assessed to determine the appropriate fixation approach. Imaging findings: X-rays are typically reviewed to understand the fracture configuration and assess whether DHS fixation may provide suitable stabilisation. Bone quality: Bone density and the quality of the surrounding bone may be considered because these factors can influence implant fixation and surgical planning. Neurovascular status: Blood circulation, sensation and movement in the affected limb may be checked to identify associated nerve or vascular concerns. General medical condition: Existing medical conditions, medications and overall fitness for surgery may be reviewed, particularly in older patients with hip fractures. Surgical planning: The doctor may discuss the fixation method, expected hospital stay, rehabilitation requirements and whether any additional treatment may be required based on the clinical and imaging findings.
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