12 Dhs

DHS/DCS Dynamic Hip and Condylar
Screw System. Designed to provide

stable internal fixation.
Technique Guide
Table of Contents
Introduction Dynamic Hip Screw (DHS) 2
Dynamic Condylar Screw (DCS) 3
Indications 4
Surgical Technique DHS 5
DCS 14
Special Techniques Using the DHS / DCS One-Step Insertion Wrench 23
Using the DCS for Subtrochanteric Fractures 28
Assembling the Instrumentation 37
Reinserting the 2.5 mm Threaded Guide Wire 41
Implant Removal 42
Product Information Implants 43
Instruments 46
Set Lists 53
Image intensiﬁer control
Synthes
Dynamic Hip Screw (DHS)
The Dynamic Hip Screw is designed to provide strong and

stable internal fixation of a variety of intertrochanteric,
subtrochanteric and basilar neck fractures, with minimal
soft tissue irritation.
Strong
The DHS plates are made of 316L stainless steel and are
cold-worked for strength.
Stable
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.
DCP (dynamic compression plate) holes in the DHS 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
Two flats within the DHS plate barrel correspond to the

two-flat design of the DHS/DCS lag screw, preventing rotation
of the lag screw within the barrel. The two-flat design also
eases insertion of the plate over the DHS / DCS lag screw.
Minimal soft tissue irritation

The DHS plates have a low-profile design, reducing the risk
of trochanteric bursitis.
The DHS plates are available in a wide range of sizes and

barrel angles, with standard or short barrels, for varied
clinical situations.
The DHS / DCS lag screw, available from 50 mm to 145 mm

lengths, easily glides within the DHS plate barrel for controlled
collapse and impaction of fragments. When the fracture
requires additional intraoperative compression, the DHS / DCS
compression screw can be used; only one size compression
screw is needed.
The DHS instruments provide direct measurements throughout

the DHS procedure, allowing proper reaming, tapping and
lag screw insertion depth. The built-in stop and locking nut
on the DHS triple reamer prevent over-reaming.
2 Synthes DHS / DCS Dynamic Hip and Condylar Screw System Technique Guide
Dynamic Condylar Screw (DCS)
The Dynamic Condylar Screw is designed to provide strong

and stable internal fixation of certain distal femoral and
subtrochanteric fractures, with minimal soft tissue irritation.
Strong
The DCS plates are made of 316L stainless steel and are
cold-worked for strength.
Stable
The two holes closest to the barrel accept 6.5 mm cancellous
bone screws. This enhances stability by allowing additional
fixation of the most distal condylar fracture fragments or
fixation of the most proximal subtrochanteric fracture fragments.
DCP holes in the DCS side plate allow angulation of 4.5 mm

cortex screws and axial compression across a shaft fracture.
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.
Two flats within the DCS plate barrel correspond to the

two-flat design of the lag screw, preventing rotation of the
DHS / DCS lag screw within the barrel. The two-flat design
also eases insertion of the plate over the DHS / DCS lag screw.
Minimal soft tissue irritation

The low-profile design reduces the risk of iliotibial band
irritation (distal femoral fractures) and trochanteric bursitis
(subtrochanteric fractures).
The DCS plates are available with 6 to 16 holes, for varied

clinical situations. The DHS / DCS lag screw is available in
50 mm to 145 mm lengths. The DHS / DCS compression
screw can be used for additional compression; only one
size compression screw is needed.
The DCS instruments also provide direct measurements

throughout the DCS procedure, allowing proper reaming,
tapping, and lag screw insertion depth. The built-in stop and
locking nut on the DCS triple reamer prevent over-reaming.
Synthes 3
Indications
DHS
The DHS is indicated for the following fractures
of the proximal femur:
– Intertrochanteric fractures
– Subtrochanteric fractures*
– Basilar neck fractures
The DHS is indicated for stable fractures, and unstable fractures

in which a stable medial buttress can be reconstructed. The
DHS provides controlled collapse and compression of fracture
fragments. This results in stable fixation and prevents undue
stress concentration on the implant.
* For certain subtrochanteric fractures, a 95° device is the

implant of choice (See “Using the DCS for Subtrochanteric
Fractures,” page 28).
DCS
The DCS is indicated for the following fractures of the
distal femur:
– Intercondylar fractures**
– Supracondylar fractures**
– Unicondylar fractures**
** The following anatomic conditions should exist:

– 4 cm of distal femur should remain intact to provide support
for the implant.
– A distal portion of the medial condyle should be intact for
the DHS/DCS lag screw to gain good purchase.
If these conditions do not exist, a Synthes 4.5 mm LCP

condylar plate or LCP distal femur plate should be considered.
The DCS is indicated for the following fractures of the

proximal femur:
– Transverse subtrochanteric fractures†
– Short oblique subtrochanteric fractures†
– Long oblique subtrochanteric fractures†
† With the lesser trochanter avulsed or on the distal

fragment (femoral shaft).1
1. Roy Sanders and P. Regazzoni. “Treatment of Subtrochanteric Femur Fractures

Using the Dynamic Condylar Screw.” Journal of Orthopaedic Trauma, vol. 3,
no. 3. New York: Raven Press, 1989. 206-213.
Surgical Technique — DHS
Plate selection
Barrel length
The standard 38 mm barrel length is most commonly indicated.
The 25 mm short barrel is indicated for specific clinical

situations, including:
– Cases in which the standard barrel may not provide sufficient
glide for the lag screw; i.e., a long impaction distance
is expected
– A medial displacement osteotomy
– Unusually small femurs
Barrel angle
An evaluation of the angle subtended between the femoral
neck and shaft axes (CCD, or collum-center-diaphysis, angle)
of the uninjured femur will aid in the selection of the most
appropriate barrel angle. The 135° barrel angle is most
commonly indicated.
Note: Greater barrel angles may produce biomechanical

advantages in unstable cases; i.e., better gliding characteristics
and reduced bending stresses on the plate / barrel junction,
although correct placement of the implant becomes technically
more difficult as barrel angles increase.2
38 mm barrel 25 mm barrel
2. P. Regazzoni, Th. Rüedi, R. Winquist, and M. Allgöwer. The Dynamic Hip Screw
Implant System. Berlin: Springer-Verlag, 1985. 5.
Synthes 5
Surgical Technique — DHS continued
1
Reduce fracture
Instruments
338.01– DHS Angle Guides

338.04
900.723 2.5 mm Threaded Guide Wire
Reduce the fracture. Determine anteversion by placing a

2.5 mm threaded guide wire anteriorly along the femoral
neck, using the appropriate DHS angle guide. Gently hammer
the wire into the femoral head. This anteversion wire will later
allow correct placement of the central guide wire in the
center of the femoral head.
2
Insert guide wire
Instruments
310.19 2.0 mm Drill Bit
338.01– DHS Angle Guides

338.04
Align the appropriate DHS angle guide along the axis of

the femoral shaft, and place it on the femur. Point the guide
tube toward the center of the femoral head. Predrilling of
the lateral cortex with the 2.0 mm drill bit is recommended
in dense bone. Insert a 2.5 mm threaded guide wire through
the appropriate DHS angle guide, parallel to the anteversion
wire and directed toward the center of the femoral head.
This point of introduction varies with barrel angle. When a
135° barrel angle is used, the guide wire enters the proximal
femur approximately 2.5 cm distal to the vastus ridge.
Notes:
Because it is designed for use with the DHS / DCS instruments
and implants, the 2.5 mm threaded guide wire, and not an
alternative wire, must be used.
This guide wire remains in place throughout the procedure.

If it is inadvertently withdrawn, reinsert it immediately (see
“Reinserting the 2.5 mm Threaded Guide Wire,” page 41).
Synthes 7
3
Confirm placement
Confirm placement of the 2.5 mm threaded guide wire
under image intensification. It must lie along the axis of the
femoral neck in both the AP and lateral views, and parallel
to the anteversion wire. If its position is incorrect, insert a
new guide wire. Remove and discard the anteversion wire.
4
Determine insertion depth
Instrument
338.05 DHS / DCS Direct Measuring Device
Slide the direct measuring device over the guide wire to

determine guide wire insertion depth. Calibration on the
measuring device provides a direct reading.
5 a.
Calculate reaming depth and lag screw length
To calculate reaming depth, tapping depth and lag screw
length, subtract 10 mm from the reading. For example:
b.
a. Direct reading 105 mm

b. Reamer setting 95 mm
c. Tapping depth (optional) 95 mm
Lag screw length 95 mm c.
6
Ream to predetermined depth
Instruments
338.13 DHS Triple Reamer

or
338.43* DHS Triple Reamer (for short barrel plates)
532.010* Small Battery Drive
532.015* Large Quick Coupling
532.032* Battery Casing
532.033* 14.4 V Battery
Assemble the appropriate DHS triple reamer (for either the

standard or short barrel DHS plate) (see “Assembling the
Instrumentation,” page 37). Set the reamer to the correct
depth. Insert the DHS triple reamer into the small battery
drive using the large quick coupling attachment. Slide the
reamer over the guide wire to simultaneously drill for the
lag screw, ream for the plate barrel, and countersink for the
plate / barrel junction to the preset depth. When reaming in
dense bone, continuously irrigate the DHS triple reamer to
prevent thermal necrosis.
* Also available
Synthes 9
7
Tap to predetermined depth (optional)
Instruments 95 mm
338.08 DHS / DCS T-Handle
338.17 Tap for DHS / DCS, 12.5 mm diameter
338.18 DHS / DCS Centering Sleeve, short
If necessary, tap to the predetermined depth using the tap

assembly (see “Assembling the Instrumentation,” page 38).
Tapping depth can be seen through the window in the short
centering sleeve.
8
Insert lag screw
Instruments
338.06 DHS / DCS Wrench
338.19 DHS / DCS Centering Sleeve, long
338.20 DHS / DCS Coupling Screw
338.21 DHS / DCS Guide Shaft
Select the DHS / DCS lag screw and assemble the lag screw
insertion assembly (see “Assembling the Instrumentation,”
page 39). Slide the assembly over the guide wire and into
the reamed hole. Seat the long centering sleeve in the hole
to center and stabilize the assembly. Insert the lag screw by
turning the handle clockwise, until the zero mark on the
assembly aligns with the lateral cortex. The threaded tip of
the lag screw now lies 10 mm from the joint surface. The lag
screw may be inserted an additional 5 mm in porotic bone,
for increased holding power and additional controlled collapse.
Note: Keep continuous forward pressure on the DHS / DCS

wrench while advancing the lag screw.
9
Align handle
Before removing the assembly, align the handle so it is in the
same plane as the femoral shaft (parallel to the femoral shaft
axis when viewed laterally). This allows proper placement of
the DHS plate onto the lag screw.
10
Remove wrench
Instruments
532.022* Quick Coupling for K-Wires
Remove the DHS / DCS wrench and long centering sleeve.

Slide the appropriate DHS plate onto the guide shaft/lag
screw assembly until it contacts the lateral cortex. Loosen
and remove the coupling screw and guide shaft. Use the
small battery drive in reverse, with the quick coupling for
K-wires, to withdraw the 2.5 mm threaded guide wire.
* Also available
Synthes 11
11
Seat plate
Instrument
338.28 DHS / DCS Impactor
Gently seat the plate with the DHS / DCS impactor. The vastus
ridge may be chiseled to further seat the plate on bone.
12
Fix plate to femur
Using AO standard screw insertion technique, fix the DHS plate
to the femur with 4.5 mm cortex screws.
13
Insert compression screw (optional)
Instrument
314.27 Large Hexagonal Screwdriver
For further, intraoperative compression of the trochanteric

fracture, the DHS / DCS compression screw may be inserted
into the lag screw. The DHS / DCS compression screw may be
used in unstable fractures to prevent disengagement of the
lag screw from the plate barrel in non-weight-bearing patients.
Note: Use of the compression screw may cause stripping

of the lag screw thread in porotic bone.
Synthes 13
Surgical Technique — DCS
1
Reduce fracture
Instrument
Reduce the fracture. The fracture can be temporarily stabilized

with 2.5 mm threaded guide wires or Steinmann pins. Place
these wires so they do not interfere with subsequent positioning
of the DCS implant assembly (see illustrations accompanying
Step 3 for proper implant positioning). In intercondylar
fractures, the wires should be replaced with independent
6.5 mm or 7.3 mm cannulated screws or 6.5 mm cancellous
bone screws with washers.
2
Determine direction of central guide wire B
25º
Instrument
292.20 2.0 mm Kirschner Wire
To determine the direction of the central guide wire, flex the

B
knee to 90°, and mark the axis of the knee joint by placing
a K-wire distally over the condyles (A). Place a second K-wire
anteriorly over the condyles (B).
A
Note: Placement of the guide wire determines placement
of the DCS implant assembly. Misplacement of the guide
wire can result in varus/valgus or rotational malalignment
of the fracture fragments.
3
Insert central guide wire
Instruments
338.41 DCS Drill Guide

AP view: C is parallel to A
Using the DCS drill guide, insert the central guide wire (C)
parallel to the distal K-wire (A) in the AP view, and parallel
to the anterior K-wire (B) in the axial view. Do not insert the
guide wire too far medially; consider the inclination of the
medial wall of the distal femur. In the sagittal plane, the Axial view: C is parallel to B
central guide wire enters the distal femur at a point anterior
to the midline between the condyles, and in line with the
shaft axis, approximately 2 cm from the knee joint.
Confirm placement of the central guide wire under image

intensification. If it is not parallel to the knee joint axis, insert
a new 2.5 mm threaded guide wire.
Notes:

If it is inadvertently withdrawn, reinsert it immediately (see 2 cm
2/3 1/3
Synthes 15
Surgical Technique — DCS continued
4
Determine guide wire insertion depth
Instrument
Slide the direct measuring device over the guide wire, and
80 mm
5 a. b.
a Direct reading 80 mm
b Reamer setting 70 mm
c Tapping depth (optional) 70 mm
If the compression screw will be used, allow for additional

compression of the fracture by selecting a lag screw
5 mm shorter (in this case, 65 mm) and inserting it an
additional 5 mm.
6
Instruments
338.46* DCS Triple Reamer, complete

(includes DCS Reaming Head (338.47),
8.0 mm Drill Bit (338.10) and Nut)
532.033* 14.4 V Battery
Assemble the DCS triple reamer (see “Assembling the

depth. Insert the DCS triple reamer into the small battery
plate/barrel junction to the preset depth. When reaming in
dense bone, continuously irrigate the DCS triple reamer to
7
Instruments
If necessary, use the tap assembly to tap to the predetermined

depth, which can be seen through the window in the short
centering sleeve (see “Assembling the Instrumentation,”
page 38).
* Also available
Synthes 17
8
Assemble lag screw insertion assembly
Instruments
Select the correct length DHS / DCS lag screw and assemble
the lag screw insertion assembly (see “Assembling the
Instrumentation,” page 39). Slide the assembly over the
guide wire and into the reamed hole. Seat the long centering
sleeve in the hole to center and stabilize the assembly.
Note: Keep continuous forward pressure on the DHS / DCS

wrench while advancing the lag screw.
9
Insert lag screw
Insert the lag screw by turning the handle clockwise until the
0 mark on the assembly aligns with the lateral cortex. The
threaded tip of the lag screw now lies 10 mm from the medial
cortex. The lag screw may be inserted an additional 5 mm in
porotic bone, for increased holding power.
Note: If a lag screw 5 mm shorter than reaming and tapping

depth is used (in this case, 65 mm), insert it an additional 5 mm,
until the 5 mark on the assembly aligns with the lateral cortex.
10
Align handle
Before removing the assembly, align the handle so it is parallel
with the femoral shaft axis when viewed laterally. This allows
proper placement of the DCS plate onto the lag screw.
11
Remove wrench
Instruments

Slide the appropriate DCS plate onto the guide shaft / lag
screw assembly. Loosen and remove the coupling screw and
guide shaft. Use the small battery drive in reverse, with the
quick coupling for K-wires, to withdraw the guide wire.
* Also available
Synthes 19
12
Seat plate
Instrument
Gently seat the plate with the DHS / DCS impactor. The lateral
condylar cortex may be chiseled to further seat the plate
on bone.
13
Compress distal fragments with compression screw
Instrument
If the joint fragments were not previously reduced with

independent 6.5 mm cancellous bone screws, the DHS / DCS
compression screw may be inserted into the lag screw. In
porotic bone, insert the screw very carefully to avoid stripping
the lag screw thread.
14
Insert 6.5 mm cancellous screws
Further interfragmentary compression can be achieved by
using two 6.5 mm cancellous bone screws through the distal
round holes of the DCS plate.
15
Compress to femoral shaft
Instrument
321.12* Articulated Tension Device
Once an approximate anatomic reduction is achieved, use

the articulated tension device to produce final compression
between the femoral shaft and distal fragments. To facilitate
reduction of the diaphyseal fragment, particularly in cases of
medial comminution with shortening, the tension device can
also be used as a distractor.
* Also available
Synthes 21
16
Fix plate to femur
Using AO standard screw insertion technique, fix the
DCS plate to the femur with 4.5 mm cortex screws.
Special Techniques — Using the DHS/DCS One-Step Insertion Wrench
DHS/DCS One-Step Insertion Wrench Assembly
Wrench DHS Plate Centering Sleeve DHS / DCS One Step

338.302 281.xxx 338.32 Lag Screw
280.2xx
Coupling
280.3xx
Screw
338.31
1
Insert guide wire
Instruments
338.047 Variable Angle Guide for DHS
Set the variable angle guide for DHS to the desired angle.
Insert the tip of the 2.5 mm threaded guide wire to the
subchondral bone in the femoral head.
Use the DHS / DCS direct measuring device to determine the

length of the guide wire.
To determine reaming depth and lag screw length, subtract

10 mm from the reading.
Synthes 23
Special Techniques — Using the DHS/DCS One-Step Insertion Wrench continued
2
Ream for lag screw and plate
Instruments
338.13 DHS Triple Reamer

or
338.43* DHS Triple Reamer (for short barrel plates)
338.17 DHS / DCS Tap
338.18 Centering Sleeve
Ream the hole for the lag screw and plate over the correctly
positioned guide wire. (See “Assembling the Instrumentation,”
page 37.)
Tap using the DHS / DCS tap with centering sleeve.

(See “Assembling the Instrumentation,” page 38)
*Also available
3
Assemble wrench
Instruments
338.302 One-Step Insertion Wrench
338.31 Coupling Screw
338.32 Centering Sleeve
Insert the coupling screw into the one-step insertion wrench

and slide the DHS plate onto the shaft of the wrench.
Select the appropriate length lag screw and place on the end
of the wrench; the flats of the lag screw must be aligned with
the flats on the wrench. Thread the coupling screw into the
end of the lag screw.
Synthes 25
Special Techniques — Using the DHS/DCS One-Step Insertion Wrench continued
3
Assemble wrench continued
Place the centering sleeve onto the wrench between the lag
screw and the plate.
Slide the assembly over the 2.5 mm guide wire and into the
reamed hole.
4
Insert lag screw
Turn the wrench clockwise until the back of the lag screw is
seated in the lateral cortex (as observed through the window
on the centering sleeve).
Align the wrench handle with the long axis of the femoral
shaft. The tip will be 10 mm from the tip of the guide wire.
10 mm
To remove the centering sleeve from the wrench, twist the
inner and outer sleeves in opposite directions.
5
Insert plate
Instrument
Advance the side plate along the shaft of the wrench and
manually insert the barrel into the reamed hole.
Seat the plate with the DHS / DCS impactor. Make certain that
the wrench shaft lies in the channel of the impactor.
Affix the plate to the proximal femur with 4.5 mm cortex

screws, using standard AO technique.
Synthes 27
Special Techniques — Using the DCS for Subtrochanteric Fractures
The design of the DCS plate can enhance fixation of selected,

stable subtrochanteric fractures because it permits stable
fixation in the proximal fragment.3 The DCS plate has a 95°
barrel angle, allowing it to enter the femur more proximally
than the DHS plate and allowing insertion of independent
screws into the calcar. Further, its two round proximal plate
holes permit insertion of 6.5 mm cancellous bone screws,
for stable proximal fixation.
Stable transverse and short oblique subtrochanteric

fractures
When using the DCS plate for these fractures, the plate can act
as a tension band against normal medial compressive forces.4
Long oblique subtrochanteric fractures

When using the 135° DHS plate to treat long oblique
subtrochanteric fractures, use of the proximal plate screws
can prohibit compression. With the 95° DCS plate, however,
stable fixation can be achieved by lagging the fracture through
the plate, since controlled collapse is not anticipated.
Note: When used in the proximal femur, the DCS plate can
only be used to treat stable fractures; i.e., fractures that can
be directly reduced and anatomically reassembled to allow
restoration of the bony medial buttress. Because the DCS
plate has a 95° barrel angle, it does not allow for controlled
collapse and compression.
3. Roy Sanders and P. Regazzoni. “Treatment of Subtrochanteric Femur Fractures

Using the Dynamic Condylar Screw.” Journal of Orthopaedic Trauma, vol. 3,
no. 3. New York: Raven Press, 1989. 211.
4. Ibid., 212.
Preoperative considerations
Plate selection
Select the DCS plate so there are four screws (eight cortices)
distal to the fracture in hard diaphyseal bone, or five screws
(ten cortices) in porotic bone.
Insertion of the 2.5 mm threaded guide wire

Though the general insertion area of the guide wire is known,
the precise insertion point varies with the CCD angle, the
angle subtended between the femoral neck and shaft axes.
Assessment of the CCD angle will allow subsequent placement
of the lag screw in its optimal position — in the center of the
femoral neck and in the inferior half of the femoral head
(see illustration). This insertion point should be determined
preoperatively with the aid of planning templates.
Note: The insertion point of the guide wire will vary with
CCD angle (angle subtended between the femoral neck and
shaft axes), as depicted by the valgus femur in the figure
(dotted lines). Example is exaggerated for clarity.
Synthes 29
Special Techniques — Using the DCS for Subtrochanteric Fractures continued
1
Reduce fracture
Instrument
Reduce the fracture. Determine anteversion by placing a

2.5 mm threaded guide wire anteriorly along the femoral
neck, gently hammering it into the femoral head. This
anteversion wire will ensure correct placement of the
central guide wire.
2
Insert guide wire
Instruments
310.19 2.0 mm Drill Bit
338.41 95º DCS Drill Guide
Place the 95º DCS drill guide along the axis of the femoral
shaft so the central guide wire will enter the femur slightly
anterior to the midpoint of the greater trochanter, near
the vastus ridge. The precise level at which the guide wire
enters the femur should be determined preoperatively (see
“Preoperative considerations,” page 29). Insert the central
guide wire parallel to the anteversion wire in the lateral view.
Predrilling of the lateral cortex with the 2.0 mm drill bit is
recommended in dense bone.
Notes:

If it is inadvertently withdrawn, reinsert it immediately (see
3
Confirm placement
Confirm placement of the central guide wire under image
intensification, in two views. In the AP view, the wire should
lie in the center of the neck and in the inferior half of the
femoral head. In the lateral view, it should lie in the middle
of the femoral head. The tip of the guide wire should just
engage the subchondral bone. If its position is incorrect, insert
a new guide wire. Remove and discard the anteversion wire.
4
95 mm
Determine insertion depth
Instrument
Slide the direct measuring device over the guide wire to

5 a. b.
a. Direct reading 95 mm
b. Reamer setting 85 mm
c. Tapping depth (optional) 85 mm
Synthes 31
6
Instruments
338.46* DCS Triple Reamer, complete

(includes DCS Reaming Head (338.47),
8.0 mm Drill Bit (338.10) and Nut)
532.033* 14.4 V Battery
Assemble the DCS triple reamer (see “Assembling the

depth. Insert the DCS triple reamer into the small battery
plate/barrel junction to the preset depth. When reaming in
dense bone, continuously irrigate the DCS triple reamer to
7
85 mm
Instruments
Secure the proximal fragment with a bone forceps to prevent

rotation in the sagittal plane. If necessary, tap to the prede-
termined depth using the tap assembly (see “Assembling
the Instrumentation,” page 38). Tapping depth can be seen
through the window in the short centering sleeve.
* Also available
8
Insert lag screw
Instruments
Select the lag screw and assemble the lag screw insertion
assembly (see “Assembling the Instrumentation,” page 39).
Slide the assembly over the guide wire and into the reamed
hole. Seat the centering sleeve in the hole to center and
stabilize the assembly, and insert the lag screw by turning the
handle clockwise until the 0 mark on the assembly aligns
with the lateral cortex. The threaded tip of the lag screw
now lies 10 mm from the medial cortex. The lag screw may
be inserted an additional 5 mm in porotic bone, until the
5 mm mark aligns with the lateral cortex, for increased
holding power.
9
Align handle
Before removing the assembly, align the handle so it is in the
same plane as the femoral shaft (parallel with the femoral
shaft axis when viewed laterally). This allows correct placement
of the DCS plate onto the lag screw.
* Also available
Synthes 33
10
Remove wrench
Slide the appropriate DCS plate onto the guide shaft / lag
screw assembly.
11
Seat plate
Instruments
Loosen and remove the coupling screw and guide shaft. Use
the small battery drive in reverse, with the quick coupling for
K-wires, to withdraw the guide wire. Gently seat the plate
with the DHS / DCS impactor. The vastus ridge can be chiseled
to further seat the plate on bone.
* Also available
12
Insert cancellous bone screws
Instruments
310.31 3.2 mm Drill Bit, quick coupling
310.44 4.5 mm Drill Bit, quick coupling
312.48 4.5 mm / 3.2 mm Insert Drill Sleeve
Insert two 6.5 mm cancellous bone screws through the proximal

round holes of the DCS plate, using lag screw technique. To
do so, drill a hole through the near cortex with the 4.5 mm
drill bit. Fully seat the 4.5 mm / 3.2 mm insert drill sleeve into
the hole. Drill through the sleeve and penetrate the far cortex
with the 3.2 mm drill bit. Measure, tap and insert the 6.5 mm
cancellous bone screw. This technique will prevent the drill
bit from gliding along the calcar.
13
Insert compression screw
Instrument
Insert the DHS / DCS compression screw into the lag screw.
This will prevent disengagement of the lag screw from the
plate barrel.
Synthes 35
14
Compress to femoral shaft
Instrument
321.12* Articulated Tension Device
Once an approximate anatomic reduction is achieved, the

articulated tension device may be used to produce final
compression of the fracture.
Note: Do not use the tension device if extensive

comminution exists.
15
Fix plate to femur
Using AO standard screw insertion technique, fix the DCS plate
to the femur with 4.5 mm cortex screws.
* Also available
36 Synthes DHS/DCS Dynamic Hip and Condylar Screw System

Special Techniques — Assembling the Instrumentation
Triple reamer assembly
Instruments
338.11 DHS Reaming Head, standard
338.13 DHS Triple Reamer, complete (includes 338.11)
338.44 DHS Reaming Head, short
338.47 DCS Reaming Head
Caution: The components of the triple reamers are sharp

and should be handled carefully.
Note: The triple reamers can be assembled preoperatively.

Reaming depth is set intraoperatively.
338.13
Select the reaming head that corresponds to the chosen plate
(DHS or DCS) and barrel length (DHS standard or DHS short).
Align the setscrew on the reaming head with the flat on the
Setscrew Flat
drill bit. Slide the cutting end of the reaming head over the
coupling end of the drill bit.
Hold the coupling end of the drill bit with one hand, and
continue sliding the reaming head along the drill bit with
the other hand. The proper setting is attained when the
non-cutting end of the reaming head reaches the calculated
depth setting. In this example, the depth setting is 95 mm
(see inset).
Synthes 37
Special Techniques — Assembling the Instrumentation continued
Triple reamer assembly continued

Secure the reaming head into the appropriate notch,
and lock it in place with the locking nut.
Tap assembly
Instruments
Slide the short centering sleeve over the tap.
Simultaneously push the quick coupling fitting on the T-handle

and insert the tap into the fitting.
Release the collar, and check to be sure the tap is securely
seated in the handle.
Lag screw insertion assembly
Instruments
338.20 DHS / DCS Coupling Screw, short
Note: The lag screw insertion assembly must be assembled

intraoperatively after the proper length lag screw is chosen.
Insert the coupling screw into the DHS / DCS guide shaft.
Synthes 39
Special Techniques — Assembling the Instrumentation continued
Lag screw insertion assembly continued

Screw the coupling screw into the end of the lag screw.
The tabs of the guide shaft should seat into the slots of
the lag screw.
Slide the long centering sleeve over the wrench.
Firmly insert the guide shaft / lag screw assembly into the
wrench until it stops.
Special Techniques — Reinserting the 2.5 mm Threaded Guide Wire
If the guide wire is inadvertently withdrawn at any time during

the procedure, reinsert it immediately.
To reinsert guide wire if withdrawn upon removal

of triple reamer
Instruments
399.42* Hammer, 500 grams
Insert a lag screw backwards into the short centering sleeve.
Place this assembly into the bone, and use it as a guide

for reinsertion of the threaded guide wire. Cannulation in
the DHS / DCS lag screw centers the threaded guide wire
in the hole.
Use a hammer to gently reseat the threaded guide wire.
Caution: Do not continue the procedure without the

threaded guide wire, as the risk of misdirecting the triple
reamer, tap assembly, or DHS / DCS lag screw is too great.
* Also available
Synthes 41
Implant Removal
Implant removal
Instrument
Remove the plate.
Assemble the insertion wrench, using the long coupling

screw. The long coupling screw allows the surgeon to exert
traction while unscrewing the lag screw.
Align the flats inside the wrench with the flats of the lag
screw. Slide the wrench over the lag screw until it is well
over the end of the screw.
Pull on the wrench while turning it counterclockwise.
Instrument options for removal
System Will remove:
DHS
– Wrench (338.06) DHS DHS One-Step DHHS
– Long Coupling Screw (338.22) DHS DHS One-Step DHHS
DHS One-Step
– Insertion Wrench (338.302) DHS One-Step DHHS
– Coupling Screw (338.31) DHS One-Step DHHS
DHHS
– Solid Coupling Screw with DHHS
internal threads (338.313)
– Hammer Guide (03.010.059) DHHS
– Side / Fixed Hammer, 400 grams DHHS
(03.010.058)
Note: If the DHHS solid coupling screw has external threads on the back-end,
use the Inserter Extractor (356.49) and Slotted Hammer (332.20) for removal.
Implants
DHS Plates, standard barrel (38 mm barrel) ◊

Holes Shaft Length Barrel Angle
(mm) 130° 135° 140° 145° 150°
2 46 281.021 281.102 281.220 281.320 281.402
3 62 281.031 281.131 281.230 281.330 281.430
4 78 281.040 281.140 281.240 281.340 281.440
5 94 281.050 281.150 281.250 281.350 281.450
6 110 281.060 281.160 281.260 281.360 281.460
8 142 281.081 281.180 281.280 281.308 281.480
10 174 281.010 281.100 281.200 281.310 281.400
12 206 281.012 281.110 281.212 281.312 281.410
14 238 281.014 281.130 281.214 281.314 281.414
16 270 — 281.170 281.216 281.316 281.416
18 302 — 281.190 — — 281.418
20 333 — 281.020 — — 281.421
DHS Plates, short barrel (25 mm barrel)◊

(mm) 130° 135° 140° 145° 150°
2 46 281.502 281.520 281.620 281.720 281.820
3 62 281.503 281.530 281.630 281.730 281.830
4 78 281.504 281.540 281.640 281.740 281.840
5 94 281.505 281.550 281.650 281.750 281.850
6 110 281.506 281.560 281.660 281.760 281.860
DCS Plates◊
(mm) 95°
6 114 281.960
8 146 281.980
10 178 281.900
12 210 281.925
14 242 281.930
16 274 281.940
18 306 281.950
20 338 281.970
22 370 281.990
◊ Available nonsterile and sterile-packed.

Add “S” to catalog number to order sterile product.
Synthes 43
Implants continued
DHS/DCS Lag Screws, 12.7 mm diameter thread◊

– Thread length: 22 mm
– Shaft diameter: 8 mm
– Pitch: 3.0 mm
– Diameter of cannulation: 2.7 mm
Length (mm) Length (mm)

280.501 50 280.000 100
280.550 55 280.050 105
280.600 60 280.100 110
280.650 65 280.150 115
280.700 70 280.200 120
280.750 75 280.250 125
280.800 80 280.300 130
280.850 85 280.350 135
280.900 90 280.400 140
280.950 95 280.451 145
DHS/DCS Lag Screws, 14.0 mm diameter thread ◊

– Thread length: 22 mm
– Shaft diameter: 8 mm
– Pitch: 3.0 mm
– Diameter of cannulation: 2.7 mm
280.454 50 280.504 100
280.455 55 280.505 105
280.460 60 280.510 110
280.465 65 280.515 115
280.470 70 280.520 120
280.475 75 280.525 125
280.480 80 280.530 130
280.485 85 280.535 135
280.490 90 280.540 140
280.495 95 280.545 145
DHS/DCS Compression Screw ◊

280.990 36 mm

DHS/DCS One-Step Lag Screws, 12.7 mm dia. thread ◊
280.251 50 280.301 100
280.255 55 280.305 105
280.260 60 280.310 110
280.265 65 280.315 115
280.270 70 280.320 120
280.275 75 280.325 125
280.280 80 280.330 130
280.285 85 280.335 135
280.290 90 280.340 140
280.295 95 280.345 145
DHS/DCS One-Step Lag Screws, 14.0 mm dia. thread

280.651S 50 280.701S 100
280.655S 55 280.705S 105
280.660◊ 60 280.710◊ 110
280.665S 65 280.715S 115
280.670◊ 70 280.720◊ 120
280.675S 75 280.725S 125
280.680◊ 80 280.730◊ 130
280.685S 85 280.735S 135
280.690◊ 90 280.740◊ 140
280.695S 95 280.745S 145
02.102.001* Universal Locking Trochanter Stabilization

Plate, 131 mm
281.869* Trochanter Stabilization Plate, 138 mm◊
281.870* Trochanter Stabilization Plate, 148 mm◊ 02.102.001
281.869

* For trochanter stabilization plate techniques, please refer to the Universal
Locking Trochanter Stabilization Plate and Trochanter Stabilization Plate for
DHS Technique Guides
Synthes 45
Instruments
292.20 2.0 mm Kirschner Wire, 150 mm, trocar point
310.19 2.0 mm Drill Bit, 100 mm, quick coupling
311.44 T-Handle, with quick coupling
311.46 Tap for 4.5 mm Cortex and

4.5 mm Shaft Screws
312.46 4.5 mm / 3.2 mm Double Drill Sleeve
314.11 Holding Sleeve
314.15 Large Hexagonal Screwdriver Shaft
319.10 Depth Gauge, for large screws
319.97 Screw Forceps
322.43 4.5 mm DCP Hip Drill Guide
Synthes 47
Instruments continued
338.01 – DHS Angle Guides

338.04 (135°, 140°, 145° and 150°)
338.11 DHS Reaming head
338.13 DHS Triple Reamer, complete

(includes DHS Reaming Head, standard
(338.11), 8.0 mm Drill Bit (338.10) and Nut)
338.22 DHS / DCS Coupling Screw, long
338.41 95° DCS Drill Guide
Synthes 49
Instruments continued
900.723 2.5 mm Threaded Guide Wire, spade point,

230 mm
One-Step Instruments
338.047 Variable Angle Guide
338.25 Small Impactor Tip
338.302 DHS / DCS One-Step Insertion Wrench
338.32 DHS / DCS Centering Sleeve for

One-Step Insertion Wrench
Synthes 51
One-Step Instruments continued
338.740 6.0 mm / 4.5 mm Drill Sleeve
338.750 DHS Parallel Drill Guide
DHS/DCS Basic Set, with self-tapping screws (105.831) and
DHS/DCS Basic Set (105.31)
Graphic Cases
304.250 DHS / DCS Basic Set with self-tapping screws
Graphic Case (for set 105.831)
304.257 DHS / DCS Basic Set Graphic Case (for set
105.31)
Instruments (in both sets)

292.20 2.0 mm Kirschner Wire, 150 mm, trocar point,
1 pkg. of 10
310.19 2.0 mm Drill Bit, quick coupling, 100 mm, 2 ea.
4.5 mm Shaft Screws, 2 ea.
312.46 4.5 mm /3.2 mm Double Drill Sleeve
312.48 4.5 mm /3.2 mm Insert Drill Sleeve
338.01 135° DHS Angle Guide
338.28 DHS / DCS Impactor Note: For additional information, please refer to package insert.
For detailed cleaning and sterilization instructions, please refer to
338.44 DHS Reaming Head, short http://www.synthes.com/sites/NA/MedicalCommunity/Pages/Cleaning_and_Sterilization.aspx
338.47 DCS Reaming Head or to the below listed inserts which will be included in the shipping container:
—Processing Synthes Reusable Medical Devices—Instruments, Instrument Trays and Graphic
Cases—DJ1305
—Processing Non-sterile Synthes Implants—DJ1304
Synthes 53
DHS/DCS Basic Set, with self-tapping screws (105.831) and
DHS/DCS Basic Set (105.31) continued
Instruments (in both sets) continued

230 mm, 10 ea.
900.723LBL Graphic Case Labels for 2.5 mm Threaded
Guide Wire (900.723)
Implants in set 105.831

4.5 mm Cortex Screws, self-tapping
Length (mm) Qty.
214.828 28 3
214.830 30 3
214.832 32 8
214.834 34 8
214.836 36 8
214.838 38 8
214.840 40 10
214.842 42 8
214.844 44 6
214.846 46 6
214.848 48 3
214.850 50 3
214.852 52 3
214.854 54 3

4.5 mm Cortex Screws
Length (mm) Qty.
214.028 28 3
214.030 30 3
214.032 32 8
214.034 34 8
214.036 36 8
214.038 38 8
214.040 40 10
214.042 42 8
214.044 44 6
214.046 46 6
214.048 48 3
214.050 50 3
214.052 52 3
214.054 54 3
DHS Basic Set, with self-tapping screws (105.837) and
DHS Basic Set (105.37)
Graphic Cases
304.250 DHS / DCS Basic Set with self-tapping screws
Graphic Case (for set 105.837)
304.257 DHS / DCS Basic Set Graphic Case
(for set 105.37)
Instruments (in both sets)

4.5 mm Shaft Screws, 2 ea.
230 mm, 10 ea.
900.723LBL Graphic Case Labels for 2.5 mm Threaded
Guide Wire (900.723)
Note: For additional information, please refer to package insert.
Synthes 55
DHS Basic Set, with self-tapping screws (105.837) and
DHS Basic Set (105.37) continued

4.5 mm Cortex Screws, self-tapping
Length (mm) Qty.
214.828 28 3
214.830 30 3
214.832 32 8
214.834 34 8
214.836 36 8
214.838 38 8
214.840 40 10
214.842 42 8
214.844 44 6
214.846 46 6
214.848 48 3
214.850 50 3
214.852 52 3
214.854 54 3

4.5 mm Cortex Screws
Length (mm) Qty.
214.028 28 3
214.030 30 3
214.032 32 8
214.034 34 8
214.036 36 8
214.038 38 8
214.040 40 10
214.042 42 8
214.044 44 6
214.046 46 6
214.048 48 3
214.050 50 3
214.052 52 3
214.054 54 3
DHS Universal Implant Set (105.35)
Graphic Case
305.36 DHS Universal Implant Set Graphic Case
Implants
DHS / DCS Lag Screws, 12.7 mm diameter thread ◊
280.000 100 280.451 145
280.050 105 280.650 65
280.100 110 280.700 70
280.150 115 280.750 75
280.200 120 280.800 80
280.250 125 280.850 85
280.300 130 280.900 90
280.350 135 280.950 95
280.400 140
DHS / DCS Compression Screw, 3 ea.◊

Length (mm)
280.990 36
DHS Plates, standard barrel (38 mm) ◊

Angle Holes Length (mm)
281.140 135° 4 78
281.150 135° 5 94
281.160 135° 6 110
281.240 140° 4 78
281.250 140° 5 94
281.260 140° 6 110
281.340 145° 4 78
281.350 145° 5 94
281.360 145° 6 110
281.440 150° 4 78
281.450 150° 5 94
281.460 150° 6 110
DHS Plates, short barrel (25 mm) ◊

Angle Holes Length (mm)
281.540 135° 4 78
281.840 150° 4 78

Synthes 57
DCS Universal Implant Set (105.32)
Graphic Case
304.270 DCS Implant Set Graphic Case
Implants
DHS / DCS Lag Screws, 12.7 mm diameter thread ◊, 2 ea.
Length (mm)
280.501 50
280.550 55
280.600 60
280.650 65
280.700 70
280.750 75
DHS / DCS Compression Screws ◊, 6 ea.

Length (mm)
280.990 36
95° DCS Plates ◊

Holes Length (mm) Qty.
281.900 10 178 2
281.925 12 210 1
281.930 14 242 1
281.940 16 274 1
281.960 6 114 2
281.980 8 146 2


DHS One-Step Basic Set (105.839) and
DHS/DCS One-Step Basic Set (105.833)
DHS One-Step Basic Set (105.839)

Graphic Case
690.348 DHS / DCS One-Step Basic Set Graphic Case
Instruments
292.20 2.0 mm Kirschner Wire, 150 mm, trocar point,
(10 / pkg.),1 pkg.
311.44 T-Handle with quick coupling
311.46 Tap for 4.5 mm Cortex and 4.5 mm Shaft
Screws, 130 mm, 57 mm tap depth, 2 ea.
319.10 Depth Gauge for large screws
322.43 4.5 mm DCP Hip Drill Guide, neutral and load,
60 mm
338.047 Variable Angle Guide for DHS
338.05 DHS / DCS Direct Measuring Device, 200 mm
length
338.08 DHS / DCS T-Handle, with quick coupling
338.17 Tap for DHS / DCS, 12.5 mm diameter, 220 mm
338.25 Small Impactor Tip
338.302 DHS / DCS One-Step Insertion Wrench
(for One-Step Insertion Wrench)
338.32 DHS / DCS Centering Sleeve
(for One-Step Insertion Wrench)
338.44 DHS Reaming Head, for DHS Triple Reamer
(for short barrel plates)
338.740 6.0 mm / 4.5 mm Drill Sleeve
338.750 DHS Parallel Drill Guide
900.723 2.5 mm Threaded Guide Wire, 230 mm, 10 ea.
Synthes 59
DHS One-Step Basic Set (105.839) and
DHS/DCS One-Step Basic Set (105.833) continued
DHS One-Step Basic Set (105.839) continued

Implants
4.5 mm Cortex Screws, self-tapping:
Length (mm) Qty.
214.828 28 3
214.830 30 3
214.832 32 8
214.834 34 8
214.836 36 8
214.838 38 8
214.840 40 10
214.842 42 8
214.844 44 6
214.846 46 6
214.848 48 3
214.850 50 3
214.852 52 3
214.854 54 3
DHS/DCS One-Step Basic Set (105.833)

Includes all components of DHS One-Step Basic Set (105.839),
plus:

DHS One-Step Implant Set (105.352)
Graphic Case
690.344 DHS One-Step Implant Set
Graphic Case
Implants
DHS / DCS One-Step Lag Screws, 12.7 mm thread
280.265 65 280.301 100
280.270 70 280.305 105
280.275 75 280.310 110
280.280 80 280.315 115
280.285 85 280.320 120
280.290 90 280.325 125
280.295 95
130° DHS Plates, standard barrel

Holes
281.040 4
281.050 5
281.060 6

Holes
281.140 4
281.150 5
281.160 6

Holes
281.240 4
281.250 5
281.260 6

Holes
281.340 4 holes
281.350 5 holes
281.360 6 holes
280.990 DHS / DCS Compression Screw, 36 mm, 3 ea.

281.440 150° DHS Plate, standard barrel, 4 holes
281.540 135° DHS Plate, short barrel, 4 holes
281.869 Trochanter Stabilization Plate, 138 mm, 2 ea.
281.870 Trochanter Stabilization Plate, 148 mm, 2 ea.
Synthes 61
DCS One-Step Implant Set (105.321)
Graphic Case
304.295 DCS One-Step Universal Implant Set
Graphic Case
Implants
DHS / DCS One-Step Lag Screws, 12.7 mm thread, 2 ea.
Length (mm)
280.251 50
280.255 55
280.260 60
280.265 65
280.270 70
280.275 75
280.990 DHS / DCS Compression Screw, 36 mm, 6 ea.
95° DCS Plates

Holes Qty.
281.960 6 2
281.980 8 2
281.900 10 2
281.925 12 1
281.930 14 1
281.940 16 1
Also Available
Sets
01.102.001 Universal Locking Trochanter Stabilization
Plate Set
105.12 DHS / DCS Basic Screw Rack with screws
(not self-tapping)
105.35S DHS Universal Implant Set, sterile (without
graphic case)
105.352S DHS One-Step Implant Set, sterile,
without graphic case
105.355 DHS Supplemental Implant Set
105.812 DHS / DCS Basic Screw Rack with self-tapping
screws
105.831J DHS / DCS Basic Set with self-tapping screws
and
105.31J DHS / DCS Basic Set (with standard drill bits
310.20, 310.32 and 310.45 to fit Jacobs chuck)
105.837J DHS Basic Set with self-tapping screws
and
105.37J DHS Basic Set (with standard drill bits 310.20,
310.32 and 310.45 to fit Jacobs chuck)
105.839J DHS One-Step Basic Set with self-tapping
screws (with standard drill bits 310.32 and
310.45 to fit Jacobs chuck)
105.954 Small Battery Drive with 14.4 V Battery Pack Set
Implants
02.102.001 Universal Locking Trochanter Stabilization
Plate, 131 mm
DHS / DCS Lag Screws, 14.0 mm diameter thread ◊
280.454 50 280.504 100
280.455 55 280.505 105
280.460 60 280.510 110
280.465 65 280.515 115
280.470 70 280.520 120
280.475 75 280.525 125
280.480 80 280.530 130
280.485 85 280.535 135
280.490 90 280.540 140
280.495 95 280.545 145

Synthes 63
Also Available continued
Implants continued Instruments

310.20 2.0 mm Drill Bit, 85 mm, Jacobs chuck
DHS / DCS One-Step Lag Screws, 12.7 mm dia. thread
321.12 Articulated Tension Device
Length (mm)
280.330 130
338.43 DHS Triple Reamer, complete (for short
280.335 135
barrel plates)
280.340 140
280.345 145 338.720 4.5 mm / 2.0 mm Insert Wire Sleeve
(for Parallel Drill Guide)
DHS / DCS One-Step Lag Screws, 14.0 mm dia. thread 338.731 4.5 mm / 2.8 mm Insert Wire Sleeve
Length (mm) Length (mm) (for Parallel Drill Guide)
399.42 Hammer, 500 grams
280.651S 50 280.701S 100
280.655S 55 280.705S 105 532.010 Small Battery Drive
280.660 ◊
60 280.710◊
110 532.013 Quick Coupling for Drill Bits
280.665S 65 280.715S 115 532.015 Large Quick Coupling
280.670◊ 70 280.720◊ 120 532.022 Quick Coupling for K-Wires
280.675S 75 280.725S 125 532.032 Battery Casing for 14.4 V Battery
280.680◊ 80 280.730◊ 130 532.033 14.4 V Battery
280.685S 85 280.735S 135
280.690◊ 90 280.740◊ 140
Graphic Case
280.695S 95 280.745S 145
690.371 DHS Supplemental Implant Set Graphic Case

Synthes (USA) Synthes (Canada) Ltd.
1302 Wrights Lane East 2566 Meadowpine Boulevard
West Chester, PA 19380 Mississauga, Ontario L5N 6P9
Telephone: (610) 719-5000 Telephone: (905) 567-0440
To order: (800) 523-0322 To order: (800) 668-1119
Fax: (610) 251-9056 Fax: (905) 567-3185 www.synthes.com
© 1990 Synthes, Inc. or its affiliates. All rights reserved. DCS, DCP, DHS, LCP and Synthes are trademarks of Synthes, Inc. or its affiliates. Printed in U.S.A. 3/12 J3045-G

12 Dhs

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DHS/DCS Dynamic Hip and Condylar

Screw System. Designed to provide

Introduction Dynamic Hip Screw (DHS) 2

Dynamic Condylar Screw (DCS) 3

Surgical Technique DHS 5

Special Techniques Using the DHS / DCS One-Step Insertion Wrench 23

Using the DCS for Subtrochanteric Fractures 28

Assembling the Instrumentation 37

Reinserting the 2.5 mm Threaded Guide Wire 41

Product Information Implants 43

Image intensiﬁer control

The Dynamic Hip Screw is designed to provide strong and

DCP (dynamic compression plate) holes in the DHS side plate:

Two flats within the DHS plate barrel correspond to the

Minimal soft tissue irritation

The DHS plates are available in a wide range of sizes and

The DHS / DCS lag screw, available from 50 mm to 145 mm

The DHS instruments provide direct measurements throughout

The Dynamic Condylar Screw is designed to provide strong

DCP holes in the DCS side plate allow angulation of 4.5 mm

The number of screw holes per plate length is maximized,

Two flats within the DCS plate barrel correspond to the

Minimal soft tissue irritation

The DCS plates are available with 6 to 16 holes, for varied

The DCS instruments also provide direct measurements

The DHS is indicated for stable fractures, and unstable fractures

* For certain subtrochanteric fractures, a 95° device is the

** The following anatomic conditions should exist:

If these conditions do not exist, a Synthes 4.5 mm LCP

The DCS is indicated for the following fractures of the

† With the lesser trochanter avulsed or on the distal

1. Roy Sanders and P. Regazzoni. “Treatment of Subtrochanteric Femur Fractures

The 25 mm short barrel is indicated for specific clinical

Note: Greater barrel angles may produce biomechanical

338.01– DHS Angle Guides

900.723 2.5 mm Threaded Guide Wire

Reduce the fracture. Determine anteversion by placing a

310.19 2.0 mm Drill Bit

338.01– DHS Angle Guides

900.723 2.5 mm Threaded Guide Wire

Align the appropriate DHS angle guide along the axis of

This guide wire remains in place throughout the procedure.

338.05 DHS / DCS Direct Measuring Device

Slide the direct measuring device over the guide wire to

a. Direct reading 105 mm

338.13 DHS Triple Reamer

532.010* Small Battery Drive

532.015* Large Quick Coupling

532.032* Battery Casing

532.033* 14.4 V Battery

Assemble the appropriate DHS triple reamer (for either the

338.08 DHS / DCS T-Handle

338.17 Tap for DHS / DCS, 12.5 mm diameter

338.18 DHS / DCS Centering Sleeve, short

If necessary, tap to the predetermined depth using the tap

338.06 DHS / DCS Wrench

338.19 DHS / DCS Centering Sleeve, long

338.20 DHS / DCS Coupling Screw

338.21 DHS / DCS Guide Shaft

Note: Keep continuous forward pressure on the DHS / DCS

532.010* Small Battery Drive

532.022* Quick Coupling for K-Wires

Remove the DHS / DCS wrench and long centering sleeve.