Sliding Hip Screw

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Evolution of Sliding Hip Screw

The technology used to repair or fix the hip has evolved significantly. Initial repair methods used basic plate and screw constructs that required prolonged periods of nonweightbearing on the injured leg. However, as our understanding of hip fractures has evolved it has become apparent that any method we use to fix the hip needs to allow for immediate ability to put full weight on the leg, especially in elderly patients.

Due to this understanding the technology surrounding hip fracture fixation has evolved significantly and there are now several highly specialized tools to fix the hip. Which method is used depends on the “stability” of the fracture. Simply, a fracture is considered stable if the outside, or lateral, surface of the bone is intact. Stable fractures can be fixed using a special plate and screw called a sliding hip screw, while unstable fractures are fixed using a nail down the middle of the bone.

The sliding hip screw aids in healing of the hip fracture by allowing the large screw in the bone to piston through the plate on the side of the bone. This transfers downward “shear” force into “compressive” force through the site of the fracture, which allows for more efficient healing. These constructs also allow for immediate weightbearing after surgery, allowing for patients to participate in physical therapy and start their recovery sooner.

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