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Trochanteric hip fractures. Fixation failure commoner with femoral medialization, a comparison of 101 cases.

The radiographic characteristics of 27 patients with a trochanteric fracture treated with a sliding hip screw in which fixation failure occurred, were compared with 74 cases having uneventful fracture union. Femoral medialization was commoner in specific fracture types, particularly if there was comminution of the lateral femoral cortex at the site of insertion of the lag screw. Femoral medialization was strongly associated with fixation failure, with a 7-fold increase in the risk of failure if medialization at more than one third occurred. These observations indicate that the value of implants preventing femoral medialization in specific types of trochanteric fracture merit further evaluation.