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Journal of Long-Term Effects of Medical Implants
SJR: 0.145 SNIP: 0.491 CiteScore™: 0.89

ISSN Druckformat: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.v22.i1.10
pages 1-10

Sliding Screw Implants for Extracapsular Hip Fractures

Andreas F. Mavrogenis
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece
George Kouvidis
Department of Orthopaedics, University of Crete, Crete, Greece
Nikolaos A. Stavropoulos
First Department of Orthopaedics, ATTIKON General University Hospital, Athens University Medical School, Athens, Greece
loannis Stavrakakis
Department of Orthopaedics, University of Crete, Crete, Greece
Pavlos Katonis
Department of Orthopaedics, University of Crete, Crete, Greece
Panayiotis J. Papagelopoulos
P.N. Soukakos Orthopaedic Research and Education Center, Sylvia Ioannou Biomechanics and Gait Analysis Laboratory, Attikon University Hospital, First Department of Orthopaedic Surgery, Medical School, National and Kapodistrian University of Athens, Athens, Greece


Hip fractures are associated with significant mortality and morbidity for the patients, more dependent residual status, and increased socio-economic cost. Many hip-fracture patients experience severe functional impairment, and most never recover their pre-fracture level of function. Current research has sought to identify the most effective treatments to reduce the incidence of hip fractures, improve survival and quality of life, and minimize complications and disability. The treatment of these fractures in the elderly aims to return these people to their pre-fracture mobility and functional level. This article reviews the surgical treatment options for extracapsular hip fractures and discusses their associated advantages, disadvantages, and complications. Two types of implants are currently available: the dynamic hip screw (DHS), and the intramedullary hip nail with one or two sliding screws. In this review, no clear advantage of one implant over another for the treatment of extracapsular hip fractures was evident. Both the DHS and hip nails can be used successfully for the treatment of stable hip fractures; for unstable fractures and low subtrochanteric fractures, hip nails are preferred. Although hip nails are associated with limited exposure, lower blood loss and transfusion requirements, and shorter operative time, complications are more common with hip nails. Long-term survival and function are similar in the two approaches. Hip nails with two sliding screws do not seem to make the difference in clinical practice that is reported in biomechanical studies.

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