Hydroxyapatite-coated screws prevent lag screw cut-out in trochanteric fractures fixed with DHS: a prospective randomized study

摘要

Dynamic Hip Screw (DHS) is widely used to treat trochanteric fractures, although significant failure rates have been reported due to lag screw cut-out. This study was designed to compare treatment with DHS fixed with either standard or hydroxyapatite-coated lag and cortical screws in elderly osteoporotic trochanteric fracture patients. The incidence of fixation failure and the functional outcomes between the two groups are reported herein. The incidence of lag screw cut-out in the standard group was similar to results seen in previous studies, but in the HA-coated screw group, no lag screw cut-out occurred. This can be attributed to the optimal osteointegration ability of the hydroxyapatite-coated screws and the resultant increased screw fixation. Hydroxyapatite-coated screws could resolve the problem of screw loosening in weak bone.