Abstract
Background: The majority of extracapsular proximal femoral fractures are treated with a sliding hip screw. The barrel of the plate can slide over the shaft of the screw in two modes; keyed (locked) or unkeyed (unlocked). The purpose of the study was to determine whether there is a difference in outcome following fixation using a sliding hip screw in the locked and unlocked modes.
Methods: A prospective randomised controlled trial of patients requiring a sliding hip screw for a proximal femoral fracture. Patients were randomised to receive a sliding hip screw either in the locked or unlocked mode. 20 patients were randomised to each group. Patients were assessed clinically and radiologically post-operatively and at three months following discharge from hospital. Screw slide and fixation failure were used as primary outcomes. A Visual analogue scoring system (VAS) was used to assess pain.
Results: A total of 40 patients were recruited in this study. The mean age of patients in the locked group was 74.05 years (range 55–90) and 78.0 years (range 65–97) in the unlocked group. There was one case of fixation failure in the locked group compared to two in the unlocked group. The mean screw slide was 10.98mm (range 1.04–37.62) in the locked group and 12.94mm (range 1.91–20.82) in the unlocked group. The pain score according to the VAS improved over the three months. There was no significant difference in pain score between the two groups.
Conclusion: When comparing screw slide, fixation failure and pain, the results show there is no significant difference between using the sliding hip screw in the locked and unlocked mode.
Theses abstracts were prepared by Mr Peter Kay. Correspondence should be address to him at The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.
