Sliding of the Compression Hip Screw in Femoral Neck Fractures

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Abstract
Summary: Backing out of the compression screw in the sliding screw–plate hip osteosynthesis was analyzed in a series of 71 hips with medial femoral neck fractures during an observation period of 12–42 months, with a median of 26 months. In addition to the compression screw device, a parallel cranial lag screw was used. A postoperative primary diastasis in the fracture space of 1–5 mm in 11 cases did not predispose to major sliding of the screws or to healing problems. Thirteen of 27 fractures with late screw telescoping of 4 mm or more showed healing disturbances, 11 late segmental collapses, and 2 nonunions, compared with 7 disturbances, 6 late segmental collapses, and 1 nonunion among 39 cases with screw gliding of 3 mm or less. The difference was significant (p < 0.05, Mann–Whitney). Five early mechanical failures were excluded from this analysis.

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