What Is the Success Rate of the Dynamic Hip Screw?
The dynamic hip screw (DHS) is one of the most widely used surgical techniques for treating certain types of hip fractures, particularly intertrochanteric fractures of the femur. Known for its reliable mechanical stability and ability to promote bone healing, the DHS has been a trusted option in orthopedic surgery for decades. But how successful is this procedure in real-world practice? Let’s take a closer look at the success rate of dynamic hip screw fixation and the factors that influence it.
High Success Rate in Stable Fractures
The dynamic hip screw boasts a success rate of around 85% to 95% when used appropriately—primarily in stable intertrochanteric fractures. These types of fractures, which occur between the greater and lesser trochanters of the femur, tend to heal well when properly stabilized, and the sliding design of the DHS allows for controlled compression that encourages natural bone healing.
In most cases, patients are able to regain functional mobility, especially when surgery is performed promptly and followed by appropriate rehabilitation. Pain levels usually decrease significantly after healing, and the need for long-term walking aids is reduced or eliminated altogether.
Factors That Influence Success
- Fracture type and stability: The DHS works best for stable intertrochanteric fractures. For unstable or comminuted fractures (where the bone is shattered into several pieces), the risk of complications or failure is higher, and other devices like intramedullary nails may be more appropriate.
- Bone quality: Patients with severe osteoporosis may experience implant loosening or screw migration, which can affect the outcome. In such cases, securing the screw in soft bone is more difficult.
- Surgical technique: Proper placement of the screw is essential. A well-aligned implant reduces the risk of cut-out (where the screw moves out of the femoral head), which is a common cause of failure in DHS procedures.
- Post-operative care: Successful recovery depends heavily on early mobilization, weight-bearing guidance, and physical therapy. Patients who follow rehab protocols are more likely to regain normal hip function.
Possible Complications
- Screw cut-out or migration
- Non-union or delayed union of the fracture
- Infection at the surgical site
- Post-operative pain or implant irritation
In rare cases, a revision surgery may be necessary if the DHS fails or the fracture does not heal properly.
Long-Term Outcomes
For most patients, dynamic hip screw fixation results in strong long-term outcomes, especially in older adults who sustain a fracture from a low-impact fall. Many regain independence and return to their usual level of activity within a few months of surgery. Long-term implant durability is also excellent, and the hardware typically does not need to be removed unless it causes discomfort.
The dynamic hip screw is a highly effective treatment for certain hip fractures, with a success rate ranging from 85% to 95% in appropriately selected cases. With proper surgical technique, attentive post-operative care, and good patient compliance, DHS fixation offers a reliable path to recovery and restored mobility. As with any surgical decision, the best outcomes come from individualized care, so it’s important to consult with an orthopedic specialist to determine whether DHS is the right solution for your specific fracture.