Whole system was originally developed as Richard screw system. The lag screw is actually Richard’s lag screw. While the smaller screw is Richard’s compression screw. Lot of confusion is there, regarding which one to call the actual Richard screw, but is actually a pointless discussion. Some call the lag screw as the Richard screw while others call the smaller one as Richard screw.
No, the DHS needs to be removed only if there is any impingement related symptoms like some constant irritation, signs of infection/inflammation or signs of AVN on radiographs. Routinely it should not be removed because the bone will be left with void that will take long to heal and will put the proximal femur at a risk of additional fracture with minor trauma.
@@Justorthothings Hi hey thankyou for prompt reply , I have a dhs and cannulated screw installed into my right hip that's why I'm asking ...I fell 18months ago. My surgeons have advised they can remove it but I'm real nervous about it ...I'm 47.....I think the general problem is the exposed part of the fitting doesn't allow the muscles to navigate work properly and so the leg does not strengthen properly....so I'm having also sorts of issues with my hips ...my joints are fine .I feel 90yrs old ! I look at the xray thinking that is a huge hole left in the hip , they said they fill it with human matter and bone will become 100percent strong in 3months .....but I just can't get my head around the removal of the dhs ...as you back the screw out through the NOF it must displace bone ? Putting pressure around the NOF so it risk of cracking the NOF ? Surgeon said it has reverse cutting thread. It sounds like a high risk operation to me ? Any thoughts comments appreciate 🙏 ...I'm in New Zealand
@@MrBoatcare Sorry for the late reply. Somehow, I missed the notification. If the screw is protruding, it will definitely affect the function of surrounding muscles. In that case, you can get the screw removed. But have to follow protected weight bearing with some assistance till there is radiological evidence of healing of implant void. For better understanding, you may share the radiograph with me on lakshaypaper@gmail.com
@@Justorthothings thankyou so much for reply I will email you latest xray. The surgeons indicated after removal that I'd be off my feet initially for the 2 weeks then slowly build up . The hip bone would be 80percent strength growing to 100percent strength In 3months ....but within that period I was advised to be extremely cautious...like I say it's been 18months since my fall and emergency surgery on the day ....I'm very grateful to the surgeons but concerned about the risks of the next operation . I've remained fit / fought hard to get moving eg I do pilates as it's floor work core targeted ....but the pain in my hip from the metalwork is really slowing me down...but I just didn't think you could remove the DHS surgeons did say it has reverse cutting thread but looking at xray to me the bones healed well around the shaft it didn't look possible???
