Research Article| Volume 41, ISSUE 4, P382-384, April 2010

Short versus long thread cannulated cancellous screws for intracapsular hip fractures: A randomised trial of 432 patients


      It is unclear which length of thread may be most advantageous for the internal fixation of an intracapsular fracture with cancellous screws. We have compared the 16 mm versus the 32 mm threads on cancellous screws within a randomised trial for 432 patients. All fractures were fixed with three screws and patients followed-up for a minimum of one year from injury.
      The characteristics of the patients in the two groups were similar with a mean age of 76 years. 23% were male. The most common complication encountered was non-union of the fracture which for undisplaced fractures occurred in 7/107 (6.5%) of short threaded screws versus 11/133 (8.3%) of long threaded screws. For displaced fractures the figures were 29/104 (27.9%) versus 24/89 (27.0%). Other complications for the short versus long threaded group were avascular necrosis (two cases versus five cases) and fracture below the implant (two cases in each group). Elective removal of the screws for discomfort was undertaken in five and three cases, respectively. None of these differences between groups was statistically significant. In summary there is no difference in fracture healing complications related to the length of the screw threads.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Injury
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • American Society of Anaesthesiologists
        New classification of physical status.
        Anaesthesiology. 1963; 24: 111
        • Frandsen P.A.
        • Andersen P.E.
        • Christoffersen H.
        • Thomsen P.B.
        Osteosynthesis of femoral neck fracture: the sliding-screw-plate with or without compression.
        Acta Orthop Scand. 1984; 55: 620-623
        • Frandsen P.A.
        • Christoffersen H.
        • Madsen T.
        Holding power of different screws in the femoral head: a study in human cadaver hips.
        Acta Orthop Scand. 1984; 55: 349-351
        • Garden R.S.
        Low-angle fixation in fractures of the femoral neck.
        J Bone Joint Surg Br. 1961; 43-B: 647-663
        • Parker M.J.
        • Palmer C.R.
        A new mobility score for predicting mortality after hip fracture.
        J Bone Joint Surg Br. 1993; 75-B: 797-798
        • Parker M.J.
        • Pryor G.A.
        • Thorngren K.-G.
        Handbook of hip fracture surgery.
        Butterworth-Heinemann Publications, Oxford1997
        • Parker M.J.
        • Stockton G.
        • Gurusamy K.
        Internal fixation implants for intracapsular proximal femoral fractures in adults (Cochrane Review).
        The Cochrane library, Issue 4. Wiley, Chichester2001
        • Qureshi K.N.
        • Hodkinson H.M.
        Evaluation of a ten-question mental test in the institutionalised elderly.
        Age Aging. 1974; 3: 152-157
        • Steinberg M.E.
        • Hayken G.D.
        • Steinberg D.R.
        A quantitative system for staging avascular necrosis.
        J Bone Joint Surg Br. 1995; 77-B: 34-41
        • Tronzo R.G.
        Hip nails for all occasions.
        Orthop Clin North Am. 1974; 5: 479-491