title: Minimally invasive sliding hip screw insertion technique.
abstract: Sliding hip screws (SHS) are commonly used for fixation of extra-capsular hip fractures, and there is increasing use of minimally invasive methods of insertion of such devices. We describe a case series of 579 consecutive patients operated on by the senior author using such a technique. Data were collected prospectively and analysed retrospectively. The technique involves a 5cm incision, retraction of vastus lateralis superiorly by a chain retractor, and use of a SHS clamp to stabilise the plate on the femur. The patients had a mean age of 81 years, surgery time of 43 minutes and hospital stay of 17 days. 77% were female and 35% required a blood transfusion post-operatively. Everyone was mobilised fully weight-bearing post-operatively. Follow-up was at six weeks for radiographic review and then subsequently at one year. The commonest complications were superficial wound infection (1.7%), detachment of the plate (0.9%) and cut-out of the lag screw (0.5%).
authors.affiliation: Department of Trauma and Orthopaedics, Peterborough City Hospital, Peterborough, UK. azkhan@doctors.org.uk
authors.forename: Asif Z
authors.initials: AZ
authors.lastname: Khan
authors.forename: Martyn J
authors.initials: MJ
authors.lastname: Parker
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D004434:Early Ambulation; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D011475:Prosthesis Failure / Q000209:etiology; D011859:Radiography; D013530:Surgical Wound Infection