Cited 3 times since 2020 (0.7 per year) source: EuropePMC Journal of orthopaedic trauma, Volume 34 Suppl 3, 1 1 2020, Pages S76-S80 Clockwise Torque of Sliding Hip Screws: Is There a Right Side? Würdemann FS, Poolman RW, Krijnen P, Bzovsky S, Sprague S, Kaptein BL, Hegeman JH, Schemitsch EH, Bhandari M, Swiontkowski M, Schipper IB, Dutch Hip Fracture Audit Group and FAITH Investigators
Objectives
This study evaluated whether patients with a left-sided femoral neck fracture (FNF) treated with a sliding hip screw (SHS) had a higher implant failure rate than patients treated for a right-sided FNF. This was performed to determine the clinical relevance of the clockwise rotational torque of the femoral neck lag screw in a SHS, in relation to the rotational stability of left and right-sided FNFs after fixation.
Methods
Data were derived from the FAITH trial and Dutch Hip Fracture Audit (DHFA). Patients with a FNF, aged ≥50, treated with a SHS, with at least 3-month follow-up data available, were included. Implant failure was analyzed in a multivariable logistic regression model adjusted for age, sex, fracture displacement, prefracture living setting and functional mobility, and American Society for Anesthesiologists Class.
Results
One thousand seven hundred fifty patients were included, of which 944 (53.9%) had a left-sided and 806 (46.1%) a right-sided FNF. Implant failure occurred in 60 cases (3.4%), of which 31 were left-sided and 29 right-sided. No association between fracture side and implant failure was found [odds ratio (OR) for left vs. right 0.89, 95% confidence interval (CI) 0.52-1.52]. Female sex (OR 3.02, CI: 1.62-6.10), using a mobility aid (OR 2.02, CI 1.01-3.96) and a displaced fracture (OR 2.51, CI: 1.44-4.42), were associated with implant failure.
Conclusions
This study could not substantiate the hypothesis that the biomechanics of the clockwise screw rotation of the SHS contributes to an increased risk of implant failure in left-sided FNFs compared with right-sided fractures.
Level of evidence
Therapeutic Level II.See Instructions for Authors for a complete description of levels of evidence.
