Dynamic Hip Screw Operation - ICID - Salisbury NHS Foundation Trust

information 

Fractured Neck of Femur Dynamic Hip Screw 

Operation 

Information for patients undergoing surgery (1 of 6) 

This leaflet is intended as a 

guide for you and your relatives 

during your stay in hospital. We 

hope this booklet answers all 

your queries, but please ask 

a member of staff if anything 

concerns you or remains unclear. 

What is the problem? 

If you need this 

information in another 

language or medium 

(audio, large print, etc) 

please contact the Patient 

Advice and Liaison 

Service (PALS) on 

0800 374 208 email: 

palservice@salisbury. 

nhs.uk 

You are entitled to 

a copy of any letter 

we write about you. 

Please ask if you want 

one when you come to 

the hospital 

We ask for information 

about you so 

that you can receive 

proper care and treatment. 

This information 

remains confidential 

and is stored 

securely by the Trust 

in accordance with 

the Data Protection 

Act 1998. 

Author: Clare Wood 

Date written: March 2004 

Approved: November 2004 

Review date: October 2010 

Version: 1.1 

Code: SNew215 

You have been admitted 

to hospital after breaking 

(fracturing), the upper part of 

your thighbone (femur), close 

to your hip joint. This is called a 

‘fractured 

neck of femur’. 

Contact: Chilmark Ward 

Tel: 01722 336262 ext. 3140/3147 

A metal plate and screws need to be put into the 

leg in order to hold the bone ends together while 

the fracture heals. 

Having this operation will also enable you to 

get back on your feet again 24 – 48 hours after 

surgery, and hopefully home within 10 days. 

This operation is called a ‘dynamic hip screw’ or 

‘DHS’. 

Do I need an operation? 

Your bone may heal if you remain in bed for up to 

12 weeks after breaking your hip. However there is a high risk that serious 

complications may develop as a result of such a long period of bed rest. 

This operation will enable you to be out of bed within two days and 

hopefully discharged from hospital within 10 days after surgery. 

This will depend on your previous level of health and independence and 

your home situation. 

The story so far…… 

You may have broken your hip after a fall. 

The bones can become weaker and more fragile with age and if you 

© Salisbury NHS Foundation Trust 

Salisbury District Hospital, Salisbury, Wiltshire SP2 8BJ 

www.salisbury.nhs.uk

Fractured Neck of Femur Dynamic Hip Screw Operation 


have underlying conditions such as osteoporosis. 

In the emergency department, you will have had an examination and x-rays confirming the 

break. 

You will also have had pain relief offered – usually in the form of an injection. 

You may have also been advised not to eat and drink (nil by mouth), as you may be going 

for an operation within a few hours. 

What happens next? 

You will be admitted to the ward where you will be welcomed by a nurse and settled onto a 

bed. 

Your pain will be assessed and you will be offered further pain relief if necessary. 

The nurse will then complete some basic tests, such as pulse, blood pressure, temperature 

and a sample of your urine will be taken. 

The nurse will also need to take some details from you relating to your general health, level 

of fitness and home situation. 

This is so that planning for your discharge can be started immediately. 

Please tell the nursing staff if you have any allergies, and if possible inform them of any 

medication you take at home. 

If you are taking medication at home, it will be useful if there is someone that can bring your 

tablets in to hospital as soon as possible. 

Who else will I meet before my operation? 

You will be seen by a junior doctor who may order more x-rays and blood tests. 

He / she will be responsible for explaining the operation to you in detail before asking you to 

sign a consent form. If you have any questions at this stage, it is important that you ask the 

doctors or nurses. 

An arrow will be drawn on the leg that requires the operation. 

You will meet an anaesthetist, who will explain your anaesthetic and pain control to you. 

The anaesthetist will examine you. He or she may also ask you about other anaesthetics 

you may have had, as well as any chest problems, and your dental history. 

Before the operation 

The operation treated as a relative emergency and we will perform your operation on the 

next available emergency-operating list. If there is to be a delay in your surgery, for any 

reason, the doctor or nurse will explain the reasons why to you. 

If you wish your family will also be informed of any delays. 


Tel: 01722 336262 ext. 3140/3147 




Pre – medication 



You may be prescribed drugs to take before your surgery to help you relax. If the doctors 

prescribe these for you, the nurse will given them to you and will advise you that you may 

feel sleepy. 

The nurse will ensure you take them and will advise you remain in bed until your operation. 

Pre – Operative Care 

To reduce the risk of being sick during your anaesthetic, you will not be allowed to eat 

anything for 6 hours before your operation. However you will be allowed to drink clear fluids 

(water, squash etc.) up to 2 hours beforehand. The nurses will let you know when you 

should stop eating and drinking. 

We will provide you with a loose fitting cotton theatre gown to wear to theatre. Cotton briefs 

may be worn if you wish. 

You will also be measured and fitted with an elastic ‘compression’ stocking to wear on your 

‘good’ leg. These reduce the risk of developing a blood clot in your legs following surgery. 

The nurses will give you an information sheet to explain the importance of this. 

The nurse will ask you to remove all jewellery, (except wedding rings, which we cover with 

tape). 

We strongly suggest your valuables be sent home with your family for safekeeping. If 

this is not possible, we will offer to put your valuables in the ward safe, and you will be 

given a receipt. If you do not wish to part with your valuables, you will be asked to sign an 

indemnity form. 

You will also be asked to remove any make up, contact lenses and false teeth. 

Transfer to theatre 

A porter will arrive to take you to theatre on your bed. A theatre nurse will welcome you 

there and check your details again. 

You will then be taken through to the anaesthetic room, where a small needle will be placed 

in the back of your hand and you will be given drugs to send you off to sleep. 

The operation 

The operation involves making a cut over your hip joint of about 8 - 12 inches in length. 

The surgeon will insert a long screw into the ball at the top of the hip joint and secure it 

with a stabilising plate and screws, which is attached to the thighbone. 

Your wound will have stitches or metal clips to keep the edges while it heals. A nurse will 

remove these 12 – 14 days following your operation. 

You may have a small drainage tube in your leg to reduce the amount of bruising. This will 

be removed on the ward 24 hours after surgery. 


Tel: 01722 336262 ext. 3140/3147 






You will have a tube (drip), into your hand or arm replacing any lost fluid with a blood 

transfusion or salt solution. 

If you have any concerns about blood transfusions, please discuss them with the doctor or 

nurse. 

It may be necessary for you to have an oxygen mask on for some time after your operation 

to help you come round from the anaesthetic. 

While you were asleep a catheter tube may have been put into your bladder to drain urine. 

This is often left in place until you are back on your feet and able to use a commode or 

toilet. 

Your pain will be assessed regularly and drugs given to keep you comfortable. Please let us 

know if you are in pain or discomfort. 

What happens next? 

After a short time in the recovery room, a nurse from your ward will come to collect you and 

take you back to the ward. 

You will continue to have your pain, blood pressure, pulse, breathing and temperature 

monitored at regular intervals for some hours after the operation. 

You will be prescribed a small daily injection of a drug called ‘Deltaparin’. This thins your 

blood slightly and further reduces the risk of blood clots, (thrombosis) in the legs and chest. 

You may have some water soon after returning to the ward. 

Tea and a light diet will be offered once you are a little less sleepy and any nausea, (sick 

feeling), has subsided. 

If you do not have a catheter tube, you will be asked to pass urine in a bottle or on a 

bedpan within 6 – 12 hours of returning to the ward. If you are unable to pass urine after this 

time a catheter may have to be inserted into your bladder to assist you. 

It may take a day or two before your bowels open. This is not unusual. The nurses will offer 

mild apperients, (laxatives), to assist your bowel actions after this period. 

The day after surgery 

You should be able to eat and drink as usual. If you are drinking plenty of water, your ‘drip’ 

will be removed. 

A phlebotomist (a person who takes blood samples), will visit you and take some blood 

from your arm. This is to ensure that you are not suffering from anaemia as a result of blood 

loss during the operation. 

It is not always necessary to give patients a blood transfusion; you may be able to have iron 

tablets instead. 

You will also have the drainage tube removed from your leg and the nurse will redress the 

wound. 


Tel: 01722 336262 ext. 3140/3147 






You may have an x-ray taken at this stage to ensure the position of the plate and screws 

is satisfactory. If the x-ray is delayed over the weekend, this should not affect your 

rehabilitation and may be done at a later date. 

Physiotherapists (‘Physio’) 

If you are recovering well the ward physiotherapist will assist you to get out of bed for the 

first time 24 hours after your operation. 

Until the bones become stronger and begin to heal, you may be required to put a little 

less weight through the leg that has been operated on. You will be given a walking frame, 

(‘Zimmer’), to assist you with walking for the first few days. 

After the first visit, the physiotherapist will see you regularly to monitor your progress and 

teach you the best way to manoeuvre on and off the bed and to walk safely. 

The physiotherapist may not see you at the weekend, but you will be expected to practice 

walking and exercise at this time. 

After a few days, depending on your progress, the physiotherapist will exchange your frame 

for crutches and encourage you to take longer walks. 

If necessary, nearer your discharge day, he/she will also teach you how to manage to walk 

up and down stairs. 

Occupational Therapists (‘OT’) 

The OT will visit you around the second or third day after your operation. 

They are responsible for enabling your safe transition between hospital and home, and will 

ask you or your family for details about your house and who helps you at home. 

For example the OT may need to know whether you have steps or stairs, how high your 

chairs or toilets are or whether you have anyone to help you with household chores or 

shopping. 

Depending on your needs, they will be able to give advice and practical help, such as 

providing bed and chair raises, high toilet seats, or installing handrails for you at home. 

If it is felt that you need extra help at home this will be discussed with you permission 

obtained to refer you to a social worker or the Hospital Alternative Team, (HAT) so that 

someone can assist you with personal care, shopping or meals. 

Your permission, or that of your nominated next of kin, is required before a referral to social 

services takes place. 

General recovery 

This surgery is major, and some patients are unable to go home within the expected 7 – 10 

days. 

If you are required to remain on hospital for a little extra rehabilitation you may be referred 

to an elderly care doctor and my be transferred to another ward in the hospital, or to a 


Tel: 01722 336262 ext. 3140/3147 






hospital nearer to your home under the care of your GP. 

It is hoped that with this extra physiotherapy and rehabilitation, you will make a full 

recovery. 

Please ask the ward sister or nursing staff if you require any further information. 

Some useful telephone numbers 

Main Hospital Number (01722) 336262 followed by: 

Chilmark Ward Ext 2640 or 2641 Fracture Clinic Ext 4176 

Physiotherapist Ext 2377 Occupational Therapist Ext 2377 

Social Worker Ext 2404 Pharmacy Help Line Ext 4270 

PALS office (Patient Advocacy Liaison Service) Ext 2960 Or freephone 0800 374 208 

The space below may be handy for any notes or questions you might have! 

Notes: 


Tel: 01722 336262 ext. 3140/3147

Dynamic Hip Screw Operation - ICID - Salisbury NHS Foundation Trust

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