A Dynamic Hip Screw (DHS) is the implant of choice for which type of intertrochanteric hip fracture?

• A Stable intertrochanteric fracture (Evans Type I, 2-part) ✓
• B Reverse oblique intertrochanteric fracture
• C Subtrochanteric fracture below the lesser trochanter
• D Basicervical femoral neck fracture

Explanation

The Dynamic Hip Screw (DHS) is the gold standard for STABLE intertrochanteric fractures (Evans Type I, 2-part; AO/OTA 31-A1 and 31-A2 with intact posteromedial cortex). The DHS allows controlled dynamic collapse of the fracture, promoting healing. For UNSTABLE patterns — reverse oblique fractures (where collapse would displace the shaft medially), subtrochanteric fractures, and highly comminuted patterns — an intramedullary device (cephalomedullary nail, e.g., PFNA, Gamma nail) is preferred as it provides greater load-sharing and mechanical stability. Basicervical fractures behave more like femoral neck fractures and may require screws or arthroplasty.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.