Fixation of XXXX . A prospective, randomised trial of three Ullevaal hip screws versus two Hansson hook-pins.

@entity1 @entity2249 @entity174 @entity39 @entity158
In a prospective, randomised trial, we compared the use of three Ullevaal hip screws with that of two Hansson hook-pins in 278 @entity1 with @entity2249 . Background factors were similar in both groups. Follow-up was for two years. There were no significant differences between the groups in length of time of surgery, hospital stay, general complications, mortality, @entity158 or walking ability. Likewise, the rates of early failure of fixation, nonunion, and the need for reoperation did not differ significantly between the groups. The use of hook-pins was associated with less drill penetrations of the femoral head during surgery (odds ratio 2.6, p = 0.05) and a lower incidence of @entity39 of the femoral head (odds ratio 3.5, p = 0.04). There was a strong relationship between poor reduction and fixation of the @entity174 and subsequent reoperation (p = 0.0005 and p = 0.0001, respectively). Likewise, peroperative drill penetration of the femoral head was associated with a greater risk of reoperation (p = 0.038). Both methods gave favourable results. In total, 22% of the @entity1 needed a major reoperation (usually hemiarthroplasty), while in 7% of the cases the fixation device needed to be removed. Osteosynthesis as the sole method for operation of all @entity2249 was thus successful in 78% of @entity1 . With selective treatment most of the remaining @entity1 would have benefited if treated by a primary arthroplasty. Accurate selection requires the development of better prognostic methods.
