Clinical evaluation of the sliding compression screw in 121 hip fractures

Between August 1975 and June 1978, the orthopedic residents at the Jacksonville Health Education Program have used the sliding compression screw to treat 135 hip fractures. The 121 of these being reported include 27 subcapital and femoral neck fractures, 88 intertrochanteric fractures, and six subtrochanteric fractures. Patients' ages ranged from 23 to 98 years, with a mean age of 64. Accurate anatomic reduction of the fracture fragments, be it open or closed, and attention to detail in the placement of the compression screws were thought to be major factors favoring a good result. As confidence was gained in the stability of fixation, appropriate patients were allowed postoperative weight-bearing regimes. It was further concluded that the ability of the sliding screw to allow for a "self-seeking equilibrium" of the fracture fragments obviated the need for primary medial displacement in unstable fractures in almost all instances.