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Sliding hip screws: modes of failure
A H Simpson1, K Varty, C A Dodd
1accident Service, John Radcliffe Hospital, Headington, Oxford.
Injury
|July 1, 1989
Summary
Sliding hip screw device failures were reviewed, with 35 mechanical failures identified. Recommendations include using locking screws and careful application of additional fixation to improve outcomes in hip fracture treatment.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Trauma care
Background:
- Sliding hip screw (SHS) devices are commonly used for hip fracture fixation.
- Understanding modes of failure is crucial for improving patient outcomes.
- Mechanical failures can lead to revision surgery and increased morbidity.
Purpose of the Study:
- To investigate the modes and causes of mechanical failure in sliding hip screw devices.
- To identify factors contributing to device malfunction.
- To provide recommendations for reducing failure rates.
Main Methods:
- Retrospective review of 223 cases involving sliding hip screw devices.
- Analysis of documented mechanical failures and their associated causes.
- Categorization of failure modes, including component separation and loss of sliding action.
Main Results:
- 35 mechanical failures were identified in 223 cases.
- Two failures involved component separation in comminuted fractures.
- 33 failures resulted from loss of sliding action due to jamming or insufficient slide.
Conclusions:
- Use of locking screws is recommended to prevent component separation in comminuted fractures.
- Careful application of additional fixation, such as cerclage wires, is advised to avoid blocking the device's barrel.
- Shorter barrelled SHS devices may offer greater sliding capacity for patients with short femoral necks.