Introduction of a self-made dynamic hip screw (DHS) angle guide (modified type) Zhou Ping, Lei Wenxue, Zhao Zhengen (Jizhu City People's Hospital, Sichuan sentence bamboo dynamic hip screw due to fixed femoral neck and intertrochanteric fractures are firm, indications Wide, fractures are easy to heal, and can be widely promoted and applied in orthopedics; however, because there is no intraoperative radiography equipment in the primary hospitals, the direction of the needles is more likely to appear higher or lower, or the structure and positioning principle are welded in the opposite direction of the dynamic hip screws. Guide the syringe, and then solder a parallel guide rod 3cm in front of the hip screw. The end of the guide rod is a vertical sounding hole. An adjustable screw is placed in the sounding hole. Finally, the hip screw and the guide tube are sawed. Or after, the neck angle is large or small, which is very difficult to introduce the hip screw. The author has designed a hip screw guide for himself. It is very convenient and successful to introduce the hip screw when there is no bedside camera. .
(Figure 1 -1 left guide) Because the distance between the guide rod and the guide needle is constant, the tip of the screw is placed close to the surface of the femoral neck, and the depth of the screw can be adjusted to determine the position of the guide needle in the femoral neck. The distance between the surface of the femoral neck (Figure 2) Figure 1 'Use method to adjust the distance between the depth measuring screw and the guide needle and tighten the screw (for example, the anteroposterior diameter of the femoral neck is estimated to be 3cm, then the distance between the adjusting screw and the guide pin is 1-5cm) ), after the fracture is reset, the joint capsule above and below the femoral neck is properly exposed (without cutting), and the upper and lower edges of the femoral neck can be touched. The plate of the self-made hip screw guide is attached under the large trochanter and will be guided. The guide rod of the device is placed in front of the central axis of the femoral neck and parallel to the femoral neck (determined by touching the femoral neck up and down), the depth of the sounding screw is attached to the surface of the femoral neck, and then the needle is guided through the needle in the guide barrel. Needle, exit the guide, and then press "AO* installation step to install the hip screw."
Clinical data Figure 2 began in August 1999 using a self-made guide for 20 cases of femoral neck, femoral intertrochanteric and subtrochanteric fractures for hip screw fixation, including 11 males and 9 females, with an average age of 51 years, femoral neck There were 3 cases of fracture, 16 cases of intertrochanteric fracture, and 1 case of subtrochanteric fracture. The results showed that the hip screw can be installed and fixed smoothly.
It is a good treatment plan to use the dynamic hip screw to fix the femoral trochanteric fracture. However, the original guide is often used to locate the needle. In particular, the primary hospital often has no intraoperative radiography equipment, which makes it difficult to install the hip screw. Or the installation is not ideal for this author to make a kind of guide, so that the success rate of hip screw installation has been significantly improved, it is worth promoting.
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