Document Detail

Prediction of fixation failure after sliding hip screw fixation.
MedLine Citation:
PMID:  15351665     Owner:  NLM     Status:  MEDLINE    
Cut-out of the lag screw is the commonest cause of fixation failure after sliding hip screw fixation of extracapsular hip fracture. A number of technical aspects of surgery have been used to asses the risk of cut-out. This study was to determine which of these indicators was the most reliable predictor of cut-out. The anterior-posterior and lateral post-operative radiographs of 23 cases of cut-out were compared with those of 77 cases of uneventful fracture healing. The tip-apex distance with correction for magnification was found to show the most significant difference between patients with cut-out against those without (P = 0.001), followed by the lag screw position on the lateral radiographs (P = 0.0095 and 0.014), reduction of the fracture on the anterior-posterior radiograph (P = 0.011 and 0.016) and the uncorrected tip-apex distance (P = 0.019). We recommend that for audit and research purposes the corrected tip-apex distance, fracture reduction and implant positioning methods should be used. For routine clinical practice, the uncorrected tip to apex distance, which is sum of the distance from the tip of the lag screw to the apex of the femoral head on anterior-posterior and lateral radiograph, and fracture reduction angle on the anterior-posterior radiograph are recommended.
Humayon Pervez; Martyn J Parker; Sarah Vowler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Injury     Volume:  35     ISSN:  0020-1383     ISO Abbreviation:  Injury     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-07     Completed Date:  2004-12-28     Revised Date:  2006-03-09    
Medline Journal Info:
Nlm Unique ID:  0226040     Medline TA:  Injury     Country:  England    
Other Details:
Languages:  eng     Pagination:  994-8     Citation Subset:  IM    
Department of Orthopaedics, Peterborough District Hospital, Peterborough PE3 6DA, UK.
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MeSH Terms
Aged, 80 and over
Bone Screws
Femur Head / pathology,  surgery
Fracture Fixation, Internal / instrumentation,  methods*
Fracture Healing / physiology
Hip Fractures / radiography,  surgery*
Internal Fixators
Prosthesis Failure
Treatment Failure
Comment In:
Injury. 2005 Aug;36(8):984-5; author reply 985   [PMID:  16023910 ]
Injury. 2005 Dec;36(12):1491   [PMID:  16242691 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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