Locking Dynamic Hip Screw Plate Specification, Uses, Sizes and Surgical Techniques

The Locking Dynamic Hip Screw Plate is designed to provide strong and stable internal fixation of a variety of intertrochanteric, subtrochanteric and basilar neck fractures, with minimal soft tissue irritation.

Locking Dynamic Hip Screw Plate

Dynamic Hip Screw Plate Specification

  • Plates are made of 316L stainless steel and Titanium.
  • The Dynamic Hip Screw Plate  are available in a wide range of sizes (3 to 16 holes) and barrel angles (130 degree, 135 degree, 140 degree, 145 degree), with 38 mm (standard) or 25 mm (short) barrels, for varied clinical situations.
  • The number of screw holes per plate length is maximized, without compromising plate strength. This allows an increased number of fixation points with a smaller incision.
  • Dynamic compression plate holes in the Plate side plate allow angulation of 4.5 mm cortex screws, for lag screw fixation of medial fragments, and allow axial compression and multiple-screw fixation of the main fragment in subtrochanteric fractures with shaft extension.
  • The Locking Dynamic Hip Screw Plate lag screw, available from 50 mm to 150 mm lengths, easily glides within the plate barrel for controlled collapse and impaction of fragments. When the fracture requires additional intraoperative compression, the Dynamic Hip Screw Plate compression screw can be used; only one size compression screw is needed.
  • Two flats within the plate barrel correspond to the two-flat design of the Dynamic Hip Screw Plate lag screw, preventing rotation of the lag screw within the barrel. The two-flat design also eases insertion of the plate over the lag screw.
  • This Plate plate has a low-profile design, reducing the risk of trochanteric bursitis.
  • The Locking Dynamic Hip Screw Plate instruments provide direct measurements throughout the  procedure, allowing proper reaming, tapping and lag screw insertion depth. The built-in stop and locking nut on the triple reamer prevent over-reaming.
  • General Instruments are available for Locking Dynamic Hip Screw Plate Plate such as Plate Bending Press, Plate Holding Forceps, Plate Bending Pliers, Bone Holding Forceps, Bone Elevators, Bone Cutter, Bone Nibbler, Depth Gauge, Sleeve, Screw Driver, Trocar Sleeve etc

Locking Dynamic Hip Screw Plate Uses

The Locking Dynamic Hip Screw Plate is indicated for the following fractures of the proximal femur:

  • Pertrochanteric fractures of type A1 and A2
  • Intertrochanteric fractures of type A3
  • Basilar neck fractures B1, B2, B3
  • Subtrochanteric fractures

The Locking Dynamic Hip Screw Plate is indicated for stable fractures, and unstable fractures in which a stable medial buttress can be reconstructed. Plate provides controlled collapse and compression of fracture fragments. This results in stable fixation and prevents undue stress concentration on the implant.

Dynamic Hip Screw Plate uses

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Locking Dynamic Hip Screw Plate Surgical Technique

Position patient

Place the patient in a supine position on the operating table.

Reduce fracture

If possible reduce the fracture while closed under the image intensifier. If an operating table without extension is used, reduce the fracture by flexion, lengthwise traction, abduction and internal rotation. Fix the fracture temporarily with Kirschner wires. Position the Kirschner wires so that they do not hamper insertion of the screw and Locking Dynamic Hip Screw plate.


The proximal femur is approached laterally. Make a 15–20 cm straight incision starting two fingerwidths proximal to the greater trochanter. Split the iliotibial tract lengthwise. Detach the M. vastus lateralis dorsally from the intermuscular membrane, retract ventrally and, if necessary, make a slight notch in the muscle in the region of the innominate tubercle. Expose the proximal femoral shaft without retracting the periosteum.

Determine antetorsion

To determine the antetorsion of the femoral neck using the Angled Guide and the T-Handle , place a Kirschner wire ventrally over the femoral neck and tap the tip slightly into the femoral head.

Determine entry point for the screw and insert guide wire

Implants with CCD angles from 130° to 150° are available. Depending on the angle of the implant, the entry point for the screw is approx. 2.5 – 6.0 cm distal to the innominate tubercle.

Locate the angled guide and drill the outer cortex using the Drill Bit 2.0 mm. Insert the Guide Wire with Threaded Tip 2.5 mm until the tip reaches the subchondral part of the femur head.

The guide wire runs approximately 6 mm proximal to Adams’ arc in the dorsocaudal quadrant of the femoral head. The thread on the tip of the guide wire stops the wire from being pulled out. Check the position of the guide wire under the image intensifier in the a.p. view and the Lauenstein position. If an extension table is used, record an axial view.

Note: Leave the guide wire in the femur until the plate is fitted. If the guide wire is not correctly positioned it must be reinserted. Once the screw is inserted in an incorrect position, no subsequent correction is possible.

Measure the length of the guide wire

Slide the Direct Measuring Device over the guide wire and measure the length of the guide wire in the bone. Remove the antetorsion Kirschner wire.


Assemble the triple reamer: Slide the Reamer over the Drill Bit 8.0 mm until it clicks into place at the selected mark. The reaming depth can be adjusted in 5 mm increments. Secure the reamer by tightening the Knurled Nut. Adjust the reaming depth on the Triple Reamer. The appropriate reaming depth is 10 mm less than the measured length of the guide wire. Ream the screw channel until the tip of the reamer is 10 mm in the subchondral part of the femoral head. The length of the appropriate screw is identical to the reaming depth.

Notes: While reaming, ensure that the guide wire does not bend. Bending the guide wire can result in incorrect placement of the Locking Dynamic Hip Screw plate and screw. If the guide wire is pulled out during reaming it must be replaced. Push the short Centering Sleeve into the drill hole and insert a screw with the shaft foremost into the centering sleeve. The guide wire can now easily be reinserted back in its original position. Remove the triple reamer.

Insert the Lag screw

Slide the insertion instruments over the guide wire and advance the long Centering Sleeve into the drilled hole. Insert the screw until the zero mark reaches the lateral cortex. Continue inserting the screw for a further 5 mm if the bone is osteoporotic. The handle of the  Wrench must remain parallel to the femoral axis since only in this screw position can the plate be positioned correctly over the flat-sided shaft of the  screw against the femoral shaft.

Position Locking Dynamic Hip Screw plate

Position the plate over the short Connecting Screw against the femoral shaft. Loosen the connecting screw and remove the Guide Shaft. Set the power tool to reverse operation to remove the guide wire. Dispose of the guide wire.

Tap Locking Dynamic Hip Screw Plate

Tap the plate into the predrilled channel using the Impactor. Compress the fracture by gentle hammer taps against the impactor.

Fix Locking Dynamic Hip Screw Plate

Using the Drill Guide 4.5 and the Drill Bit 3.2 mm, drill neutral holes through the plate holes. Fix the  plate using cortex screws 4.5 mm of the appropriate length.


The fracture fragments can also be compressed with the Compression Screw. First fix the plate to the femoral shaft with screws. Insert and tighten the compression screw. Particularly if the bone is osteoporotic, insert the compression screw carefully and ensure that the thread is not stripped. The compression screw can then be removed.

Insert  locking device (Option)

The Locking Device is used to temporarily block the sliding mechanism. In order to fully countersink the locking device in the Locking Dynamic Hip Screw plate barrel, the selected screw must be 10 mm shorter than the reaming depth. The screw must then be inserted 10 mm deeper, on the wrench reaches the lateral cortex. Tighten and secure the locking device using the Torque-indicating Screwdriver. To ensure that an optimal locking force is achieved, the locking device must be tightened to a torque.

Position trochanter stabilizing plate on Locking Dynamic Hip Screw Plate

Insert the screw and plate. If an anti-rotation screw is to be used, the screw must be inserted in a slightly more caudal direction than for the standard technique. Fix the plate by inserting a cortex screw 4.5 mm through the second proximal plate hole and insert a new guide wire. Locate the Trochanter stabilizing plate flush against the  plate.

Fix plates

Fix the Trochanter stabilizing plate and the Locking Dynamic Hip Screw plate using cortex screws 4.5 mm of the appropriate length. Depending on the indication, individual fracture fragments of the greater trochanter can be fixed against the scooped section of the Trochanter stabilizing plate using screws 4.0 mm or cerclage wires.

Insert anti-rotation screw (option)

An anti-rotation screw can be inserted cranially and parallel to the screw. Cancellous bone screws 6.5 mm, cannulated screws 7.0 mm and cannulated screws 7.3 mm can be used. Position the Parallel Drill Guide over the guide wire. Insert the appropriate drill sleeve system in the 12 mark of the guide. For the cancellous bone screws 6.5 mm tap a threaded hole. For cannulated screws 7.0 mm and 7.3 mm, insert a guide wire. Insert the screw according to the usual insertion technique. Remove the guide wire.

Locking Dynamic Hip Screw Plate Contraindications

Contraindications may be qualified or total, and need to be taken into consideration when evaluating the prognosis in each case. The physician’s education, training and professional judgement must be relied upon to choose the most appropriate device and treatment. Conditions presenting an increased risk of failure include:

  • Any active or suspected latent infection or marked local inflammation in or about the affected area.
  • Compromised vascularity that would inhibit adequate blood supply to the fracture or the operative site.
  • Bone stock compromised by disease, infection or prior implantation that can not provide adequate support and/or fixation of the devices.
  • Material sensitivity, documented or suspected.
  • Obesity. An overweight or obese patient can produce loads on the implant that can lead to failure of the fixation of the device or to
    failure of the device itself.
  • Patients having inadequate tissue coverage over the operative site.
  • Implant utilization that would interfere with anatomical structures or physiological performance.
  • Any mental or neuromuscular disorder which would create an unacceptable risk of fixation failure or complications in postoperative care.
  • Other medical or surgical conditions which would preclude the potential benefit of surgery.
  • All associated diseases which could endanger the function and success of the Locking Dynamic Hip Screw Plate.

Warnings and Precautionary for Dynamic Hip Screw Plate

Before using Locking Dynamic Hip Screw Plate, the surgeon and ancillary staff should study the safety information in these instructions, as well as any product-specific information in the product description, surgical procedures and/or brochures.

Locking Dynamic Hip Screw Plate is made from medical grade materials and are designed, constructed and produced with utmost care. These quality plate assure best working results provided they are used in the proper manner. Therefore, the following instructions for use and safety recommendations must be observed.

Improper use of  this plate can lead to damage to the tissue, premature wear, destruction of the instruments and injury to the operator, patients or other persons.

It is vital for the operating surgeon to take an active role in the medical management of their patients. The surgeon should thoroughly understand all aspects of the surgical procedure and instruments including their limitations. Care in appropriate selection and proper use of surgical instruments is the responsibility of the surgeon and the surgical team. Adequate surgical training should be completed before use of this plate.

Factors which could impair the success of the operation:

  • Allergies to implanted materials.
  • Localized bone tumours.
  • Osteoporosis or osteomalacia.
  • System disease and metabolic disturbances.
  • Alcohol and drug abuse.
  • Physical activities involving excessive shocks, whereby the implant is exposed to blows and/or excessive loading.
  • Patients who are mentally unable to understand and comply with the doctor’s instructions.
  • Poor general health.

Possible Adverse Effects

The following adverse effects are the most common resulting from implantation:

  • Loosening of the Locking Dynamic Hip Screw Plate, which may result from cyclic loading of the fixation site and/or tissue reaction of the implant.
  • Early and late infection.
  • Further bone fracture resulting from unusual stress or weakened bone substance.
  • Temporary or chronic neural damage resulting from pressure or hematomata.
  • Wound hematomas and delayed wound healing.
  • Vascular disease including venal thrombosis, pulmonary embolism and cardiac arrest.
  • Heterotopic ossification.
  • Pain and discomfort due to presence of the implants.
  • Mechanical failure of the implant, including bending, loosening or breakage.
  • Migration of implant resulting in injury.

Preoperative Planning for Locking Dynamic Hip Screw Plate

The operating planning is carried out following a thorough clinical evaluation of the patient, Also, x-rays must be taken to allow a clear indication of the bony anatomy and associated deformities. At the time of the operation, the corresponding implantation instruments in addition to a complete set of Locking Dynamic Hip Screw Plate must be available.

The clinician should discuss with the patient the possible risks and complications associated with the use of this plate. It is important to determine pre-operatively whether the patient is allergic to any of the implant materials. Also, the patient needs to be informed that the performance of the device cannot be guaranteed as complications can affect the life expectancy of the device.

Locking Dynamic Hip Screw Plate Precautions

  • Confirm functionality of instruments and check for wear during reprocessing. Replace worn or damaged instruments prior to use.
  • It is recommended to use the instruments identified for this screw.
  • Handle devices with care and dispose worn bone cutting instruments in a sharps container.
  • Always irrigate and apply suction for removal of debris potentially generated during implantation or removal.

Locking Dynamic Hip Screw Plate Warnings

  • Locking Dynamic Hip Screw Plate can break during use (when subjected to excessive forces). While the surgeon must make the final decision on removal of the broken part based on associated risk in doing so, we recommend that whenever possible and practical for the individual patient, the broken part should be removed. Be aware that implants are not as strong as native bone. Implants subjected to substantial loads may fail.
  • Instruments, screws and cut plates may have sharp edges or moving joints that may pinch or tear user’s glove or skin.
  • Take care to remove all fragments that are not fixated during the surgery.
  • While the surgeon must make the final decision on implant removal, we recommend that whenever possible and practical for the individual patient, fixation devices should be removed once their service as an aid to healing is accomplished. Implant removal should be followed by adequate post-operative management to avoid refracture.

Locking Dynamic Hip Screw Plate General Adverse Events

As with all major surgical procedures, risks, side effects and adverse events can occur. While many possible reactions may occur, some of the most common include: Problems resulting from anesthesia and patient positioning (e.g. nausea, vomiting, dental injuries, neurological impairments, etc.), thrombosis, embolism, infection, nerve and/or tooth root damage or injury of other critical structures including blood vessels, excessive bleeding, damage to soft tissues incl. swelling, abnormal scar formation, functional impairment of the musculoskeletal system, pain, discomfort or abnormal sensation due to the presence of the device, allergy or hypersensitivity reactions, side effects associated with hardware prominence, loosening, bending, or breakage of the device, mal-union, non-union or delayed union which may lead to breakage of the implant, reoperation.