We present the results of a technique of dynamic hip screw insertion through a very small incision, typically 2.5cm.

Method: The technique is performed using a standard dynamic hip screw set and requires no additional equipment. We compared the results to those of an age and sex matched group who had undergone the operation through a traditional approach. We compared the time spent in theatre, the pre and post-operative haemoglobin concentration, haematocrit, and prevalence of wound infection.

Results: 13 consecutive intertrochanteric hip fractures were treated with a dynamic hip screw and 4-hole plate by one surgeon using the percutaneous technique. There were 9 females and 4 males with a mean age of 84 years (range 62 to 96 years).

The mean post-operative drop in haemoglobin concentration in the percutaneous group was 2.2 g/dl (range 0 to 4.4 g/dl) compared to 3.5 g/dl (range 1.2–5.4) in the control group (p=0.014). The mean haematocrit drop was 0.07 (range 0 to 0.12) in the percutaneous group compared to 0.10 (range 0.03 to 0.17) in the control group (p=0.017)

The mean theatre time with the percutaneous technique was 57 minutes (range 40–75 minutes) and in the control group, 60 minutes (range 30–95). There were no wound problems.

Conclusion: To our knowledge, this technique has not been previously reported. The percutaneous technique offers a better clinical outcome at no extra expense and warrants further evaluation in a larger study