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- Talk
- 15/09/2021
- Canada
Clockwise Torque of Sliding Hip Screws: Is There a Right Side?
Description
In this presentation, Franka Wurdemann, a PhD student in trauma surgery at the Leiden University Medical Center, introduces a study titled "Clockwise Torque of Sliding Hip Screws-- Is There a Right Side?" She begins by addressing the audience and discussing the complexities surrounding femoral neck fractures, referring to them as some of the most challenging cases in hip fracture treatment, marked by high failure rates ranging from 20% to 40%.
Wurdemann highlights the critical influence of fracture type on implant failure, while raising the possibility that biomechanical factors related to the implant may be overlooked. She references a previous study indicating that right-sided trochanteric fractures are more stable than left-sided ones, hypothesizing that this discrepancy arises from the clockwise rotational torque applied during screw insertion.
She draws an analogy to bicycles, explaining the necessity of specific screw orientations to prevent loosening during cyclic motion, akin to the forces experienced in human gait. Moving on, Wurdemann sets the objective to investigate the relationship between clockwise torque and the stability of left and right-sided femoral neck fractures treated with sliding hip screws.
The study utilizes data from the Dutch Hip Fracture Audit and the FAITH trial, focusing on patients aged 50 and older with at least three months of follow-up. The primary outcome is implant failure, assessed through a multivariable logistic regression considering factors such as age, sex, fracture displacement, and mobility prior to the fracture. Results reveal that out of 1,750 patients, 4.3% experienced implant failure, with the fracture side not significantly impacting failure rates.
Wurdemann concludes that their hypothesis regarding the impact of clockwise screw rotation on implant failure risk was not supported. Nonetheless, she expresses gratitude for the opportunity to present and invites questions from the audience, while also acknowledging the contributions and support for the FAITH trial.