Clockwise Torque of Sliding Hip Screws: Is There a Right Side?

Franka S. Würdemann, Rudolf W. Poolman, Pieta Krijnen, Sofia Bzovsky, Sheila Sprague, Bart L. Kaptein, Johannes H. Hegeman, Emil H. Schemitsch, Mohit Bhandari, Marc Swiontkowski, Inger B. Schipper

Research output: Contribution to journalArticlepeer-review

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 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.

Original languageEnglish (US)
Pages (from-to)S76-S80
JournalJournal of orthopaedic trauma
Volume34
DOIs
StatePublished - Nov 1 2020

Bibliographical note

Copyright:
This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine

PubMed: MeSH publication types

  • Journal Article

Fingerprint Dive into the research topics of 'Clockwise Torque of Sliding Hip Screws: Is There a Right Side?'. Together they form a unique fingerprint.

Cite this