[4 fragment fractures of the proximal femur: is the dynamic hip screw a suitable implant?].

The DHS-implant system is widely used in the operative treatment of pertrochanteric fractures of the femur. The telescoping effect of the implant in the unstable 4-fragment fracture leads to lateralisation of the greater trochanter and shortening of the leg. The quality of reposition influences this secondary dislocation. In our series of 65 patients treated with this device 17 repositions were in a varus position, followed by leg shortening of more than 10 mm in 9 patients. Independent of the quality of reposition in the long-term follow-up only one patient of 25 complained of persistent pain.