Sliding hip screws feasible for trochanteric fractures

Sliding hip screws (SHSs) have comparable one-year outcomes to intramedullary nails (IMNs) for fixation of trochanteric hip fractures, according to a study published online June 6 in JAMA Network Open.

Emil H. Schemitsch, M.D., from the London Health Sciences Centre and Western University in Canada, and colleagues compared one-year outcomes of patients with trochanteric fractures treated with the IMN versus an SHS. The analysis included 850 patients with low-energy trochanteric fractures treated at 25 international sites across 12 countries.

The researchers found that at the one-year postsurgery follow-up (304 treated with the IMN and 317 treated with an SHS), there were no significant differences between groups in EuroQol-5 Dimension scores in unadjusted or adjusted analyses. Furthermore, for secondary outcomes, there were no between-group differences observed. Fracture stability and previous fracture were also similar between the groups.

“This randomized clinical trial found that IMNs for the treatment of trochanteric fractures had similar one-year outcomes compared with SHSs,” the authors write. “These results suggest that the SHS is an acceptable lower-cost alternative for trochanteric fractures of the hip.”

The study was funded by Stryker, the manufacturer of the IMN, and several authors disclosed ties to the company.

More information:
Emil H. Schemitsch et al, Intramedullary Nailing vs Sliding Hip Screw in Trochanteric Fracture Management, JAMA Network Open (2023). DOI: 10.1001/jamanetworkopen.2023.17164

Mai P. Nguyen et al, A Gap Between Evidence-Based Research and Clinical Practice in Management of Hip Fractures, JAMA Network Open (2023). DOI: 10.1001/jamanetworkopen.2023.17178

Journal information:
JAMA Network Open

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