Technical Tip in Dynamic Hip Screw Plate Insertion

Dynamic hip screw procedures are performed commonly by orthopaedic registrars during their training. After successful screw insertion, trainees can face the challenge of sliding the plate on the screw without impinging against the bone, and the clearing of skin and soft tissues distally. We describe a technical tip where, after the screw is inserted to the desired length, the screw is turned a quarter turn anticlockwise for a right procedure and clockwise for a left procedure (always towards the patient’s head). The plate is then inserted vertically but only partially, with the distal tip facing up. The plate together with the screw is turned so the plate is parallel to the shaft. During this manoeuvre, the skin and soft tissue can easily be retracted distally. The barrel of the plate can then be fully inserted.