Clockwise Torque of Sliding Hip Screws: Is There a Right Side?. (November 2020)
- Record Type:
- Journal Article
- Title:
- Clockwise Torque of Sliding Hip Screws: Is There a Right Side?. (November 2020)
- Main Title:
- Clockwise Torque of Sliding Hip Screws
- Authors:
- Würdemann, Franka S.
Poolman, Rudolf W.
Krijnen, Pieta
Bzovsky, Sofia
Sprague, Sheila
Kaptein, Bart L.
Hegeman, Johannes H.
Schemitsch, Emil H.
Bhandari, Mohit
Swiontkowski, Marc
Schipper, Inger B. - Abstract:
- Abstract : 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 biomechanicsAbstract : 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. … (more)
- Is Part Of:
- Journal of orthopaedic trauma. Volume 34(2020)Supplement 3
- Journal:
- Journal of orthopaedic trauma
- Issue:
- Volume 34(2020)Supplement 3
- Issue Display:
- Volume 34, Issue 3 (2020)
- Year:
- 2020
- Volume:
- 34
- Issue:
- 3
- Issue Sort Value:
- 2020-0034-0003-0000
- Page Start:
- Page End:
- Publication Date:
- 2020-11
- Subjects:
- femoral neck fracture -- implant failure -- sliding hip screw -- side -- left -- right -- clockwise torque -- rotational stability -- biomechanics
Orthopedics -- Periodicals
Wounds and injuries -- Periodicals
Orthopedics -- Periodicals
Wounds and Injuries -- therapy -- Periodicals
Periodicals
617.47044 - Journal URLs:
- http://journals.lww.com/jorthotrauma/pages/default.aspx ↗
http://www.jorthotrauma.com ↗
http://cufts2.lib.sfu.ca/CJDB/BVAS/journal/149202 ↗
http://gateway.ovid.com/ovidweb.cgi?T=JS&MODE=ovid&PAGE=toc&D=ovft&AN=00005131-000000000-00000 ↗
http://journals.lww.com ↗ - DOI:
- 10.1097/BOT.0000000000001934 ↗
- Languages:
- English
- ISSNs:
- 0890-5339
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 5027.675000
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