CORE
🇺🇦
make metadata, not war
Services
Services overview
Explore all CORE services
Access to raw data
API
Dataset
FastSync
Content discovery
Recommender
Discovery
OAI identifiers
OAI Resolver
Managing content
Dashboard
Bespoke contracts
Consultancy services
Support us
Support us
Membership
Sponsorship
Community governance
Advisory Board
Board of supporters
Research network
About
About us
Our mission
Team
Blog
FAQs
Contact us
Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial
Authors
Andrew Bucknill
Andrew Chia
+31 more
Aaron T. Creek
Akhil Dadi
Alexander de Mol van Otterloo
Alexander C. de Vries
Andrea Dolenc
Adam Dowrick
Andrew Evans
Amy L. Foley
Alisha Garibaldi
Andrew Gong
Ajay Gupta
Andrew Jennings
Anders Karlsten
Angshuman Khanna
Abdel Rahman Lawendy
Allen Liew
Andrew J. Marcantonio
Allison W. McIntyre
Aaron Nauth
Amber Oatt
Amal Shankar Prasad
Anil Rai
Amar Rangan
Amanda W. Romero
Amir Sanghavi
Andrew H. Schmidt
Anke B. Smits
Albert van Kampen
Angela Ward
Albert Yee
Abby Zellar
Publication date
15 April 2017
Publisher
Scholarship@Western
Abstract
© 2017 Elsevier Ltd Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between March 3, 2008, and March 31, 2014, we randomly assigned 1108 patients to receive a sliding hip screw (n=557) or cancellous screws (n=551). Reoperations within 24 months did not differ by type of surgical fixation in those included in the primary analysis: 107 (20%) of 542 patients in the sliding hip screw group versus 117 (22%) of 537 patients in the cancellous screws group (hazard ratio [HR] 0·83, 95% CI 0·63–1·09; p=0·18). Avascular necrosis was more common in the sliding hip screw group than in the cancellous screws group (50 patients [9%] vs 28 patients [5%]; HR 1·91, 1·06–3·44; p=0·0319). However, no significant difference was found between the number of medically related adverse events between groups (p=0·82; appendix); these events included pulmonary embolism (two patients [\u3c1%] vs four [1%] patients; p=0·41) and sepsis (seven [1%] vs six [1%]; p=0·79). Interpretation In terms of reoperation rates the sliding hip screw shows no advantage, but some groups of patients (smokers and those with displaced or base of neck fractures) might do better with a sliding hip screw than with cancellous screws. Funding National Institutes of Health, Canadian Institutes of Health Research, Stichting NutsOhra, Netherlands Organisation for Health Research and Development, Physicians\u27 Services Incorporated
Similar works
Full text
Open in the Core reader
Download PDF
Available Versions
Scholarship@Western
See this paper in CORE
Go to the repository landing page
Download from data provider
oai:ir.lib.uwo.ca:boneandjoint...
Last time updated on 23/11/2020