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130‐ versus 135‐degree sliding hip screws and failure in pertrochanteric hip fractures
Author(s) -
Radic Ross,
Yates Piers J.,
Lim Tao Shan,
Burrows Sally
Publication year - 2014
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12713
Subject(s) - medicine , lag screw , fixation (population genetics) , dynamic hip screw , orthodontics , degree (music) , surgery , femur , internal fixation , population , physics , environmental health , acoustics
Background The fixed‐angle sliding hip screw has become a popular method of fixation for pertrochanteric hip fractures. The tip‐to‐apex distance ( TAD ) concept was introduced by Baumgaertner et al . in 1995 and has subsequently become a decisive predictor of the successfulness of fixation. The 135‐degree plate has become the most popular plate used for fracture fixation, although this has not been compared with lower angled plates (130 degree) in relation to TAD . Method We analysed 567 consecutive cases of dynamic hip screw ( D e P uy‐ S ynthes) fixation to compare TAD in various angled plates and rate of failure. Results The 130‐degree plate has significantly lower mean TAD 19.3 mm versus 20.8 mm ( P = 0.016). There were nine failures because of superior screw cut‐out in the 135‐degree plates and 0 failures in the 130‐degree plates. Conclusion We believe the improved trajectory for lag screw placement using 130‐degree angled plates leads to a lower TAD and improved fixation in pertrochanteric fractures.