The stability of fixation of proximal femoral fractures: a radiostereometric analysis

D. van Embden*, G. A. N. L. Stollenwerck, L. A. Koster, B. L. Kaptein, R. G. H. H. Nelissen, I. B. Schipper

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


The aim of this study was to quantify the stability of fracture-implant complex in fractures after fixation. A total of 15 patients with an undisplaced fracture of the femoral neck, treated with either a dynamic hip screw or three cannulated hip screws, and 16 patients with an AO31-A2 trochanteric fracture treated with a dynamic hip screw or a Gamma Nail, were included. Radiostereometric analysis was used at six weeks, four months and 12 months post-operatively to evaluate shortening and rotation. Migration could be assessed in ten patients with a fracture of the femoral neck and seven with a trochanteric fracture. By four months post-operatively, a mean shortening of 5.4 mm (-0.04 to 16.1) had occurred in the fracture of the femoral neck group and 5.0 mm (-0.13 to 12.9) in the trochanteric fracture group. A wide range of rotation occurred in both types of fracture. Right-sided trochanteric fractures seem more rotationally stable than left-sided fractures. This prospective study shows that migration at the fracture site occurs continuously during the first four post-operative months, after which stabilisation occurs. This information may allow the early recognition of patients at risk of failure of fixation.
Original languageEnglish
Pages (from-to)391-397
JournalThe Bone & Joint Journal
Issue number3
Publication statusPublished - Mar 2015

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