Internal fixation implants for intracapsular hip fractures in adults

Internal fixation of fragility fracturesof the femoral neck

“…Multiple pin / screw systems and gliding hip screw systems come in different sizes and shapes, but are all based on the same two principles. At the moment there is no evidence for the superiority of either multiple pin or screw systems nor gliding implants (Parker and Gurusamy 2011). The ongoing FAITH study plans to enroll 1,500 patients with femoral neck fractures to compare the outcomes from patients randomized to multiple screws to those treated by a gliding implants (Swiontkowski 2008).…”

“…In Scandinavia, two screws or pins have long been the method of choice, whereas three screws or pins are considered gold standard in North America (Ly andSwiontkowski 2008, Gjertsen et al 2010). There is little evidence for the superiority of any fixation method and also for the optimum number of screws or pins (Parker and Gurusamy 2011).…”

Unique stability of femoral neck fractures treated with the novel biplane double-supported screw fixation method: A biomechanical cadaver study

“…Currently, there is rather a divergence of views and concepts. The majority of authors recommend placement of the distal screw so that it is supported by the distal femoral neck cortex [4,[8][9][10][14][15][16][17][18][19][20], which is traditionally called the ''calcar'', although this is not the true anatomic calcar [21]. Central screw placement on the lateral view is advised in some papers [19], while other authors suggest peripheral placement [8,10,18].…”

“…It is widely accepted that the screws should be placed parallel to each other [4,8,9,[17][18][19]22]. However, the dictum of parallel placement has not been proven [20] and some authors prefer divergent placement on the lateral view [14,20,23]. The inverted triangle configuration is usually favoured because it provides higher stability [7,8], and screw insertion at The aim of this study was to biomechanically evaluate BDSF fixation strength and compare it with the conventional fixation (CFIX) using three parallel cannulated screws.…”

Hemiarthroplasty in worst cases is better than internal fixation in best cases of displaced femoral neck fractures: A prospective study of 683 patients treated with hemiarthroplasty or internal fixation

“…Osteoporosis is more prevalent in older age groups and appears to be related to an increased risk of nonunion after internal fixation (Hedstrom 2004). On the other hand, some authors have recommended internal fixation for younger patients (Parker and Tagg 2002). Several studies have shown that the degree of initial displacement prognosticates failure, and others have found that comminution of the femoral calcar, size of the head and varus angulation affect healing (Alho et al 1991, Nilsson et al 1993.…”