Revista Brasileira de Ortopedia (Apr 2021)

Minimally Invasive Osteosynthesis of Transtrochanteric Fractures with Dynamic Hip Screw (DHS)

  • José André Melo Barreto Guimarães,
  • Marcos Cezar Feitosa de Paula Machado,
  • Pauliana Valéria Machado Galvão,
  • Jéssika Cristina de Lima,
  • Lucas dos Santos Gomes,
  • Pedro Ferreira Barreto Guimarães

DOI
https://doi.org/10.1055/s-0040-1716758
Journal volume & issue
Vol. 56, no. 1
pp. 109 – 113

Abstract

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Abstract The method presented here consists of a minimally invasive surgical technique for osteosynthesis of transtrochanteric fractures with Dynamic Hip Screw (DHS) 135º. It is indicated in the treatment of 31-A1 and 31-A2 fractures (Arbeitsgemeinschaft für Osteosynthesefragen Classification - AO) that meet the prerequisites required for using DHS. The surgery is performed, preferably, before 48 hours after the fracture. With the use of the same instruments as the traditional surgical technique and the aid of the C-arm, a closed reduction of the fracture and implantation of the DHS is performed by a 2-cm surgical incision, through dissection of the underlying tissues, with minimal bleeding and damage to the soft parts. In the immediate postoperative period, the patient is encouraged to orthostatism and walk with full load, which anticipates hospital discharge and favors early functional rehabilitation. Outpatient return is scheduled at 2, 6, 12 and 24 weeks postoperatively, with radiographic evaluation to assess fracture healing.

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