Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH)
Hip fractures are extremely common in the United Kingdom.
Due to the ageing population, the number of hip fractures is expected to increase. Hip fractures can lead to temporary, sometimes permanent, loss of independence and can affect quality of life. Hip fractures account for more hospital days than any other fractures in the body.
Femoral neck fractures are a common type of fracture of the hip. The hip joint connects the thighbone (femur) with the pelvis. Despite the name hip fracture, the break is below the hip joint, at one of two places at the upper end of the thighbone.
Following the break, severe pain occurs in the hip, groin, and thigh. It is usually impossible to get up or walk. Very occasionally when the bone is cracked rather than completely broken, walking is possible but painful.
What we did
The study was to compare two common internal fixation treatments, where the femoral neck fracture is repaired with metal screws or plates.
- Sliding hip screw.
- Cancellous screw.
1108 patients were randomly assigned to receive a sliding hip screw (557 patients) or cancellous screw (551 patients).
What we found
Re-operation rates within 24 months did not differ between the sliding hip screw group (20% patients) versus the cancellous screw group (22% patients).
Avascular necrosis was more common in the sliding hip screw group (9% patients) than in the cancellous screw group (5% patients).
There was no significant difference between the number of adverse events between groups.
Some groups of patients, such as smokers, might do better with a sliding hip screw than with a cancellous screw.
UK chief investigator
Professor Amar Rangan
Canadian Institute of Health Research
Patients with Femoral Neck Fractures Are at Risk for Conversion to Arthroplasty After Internal Fixation: A Machine-Learning Algorithm
van de Kuit, et al. (2022)
Clinical Orthopaedics and Related Research
Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial
FAITH Investigators (2017)
Fixation using alternative implants for the treatment of hip fractures (FAITH): design and rationale for a multi-centre randomized trial comparing sliding hip screws and cancellous screws on revision surgery rates and quality of life in the treatment of femoral neck fractures
FAITH Investigators (2014)
BMC Musculoskeletal Disorders
Central coordination as an alternative for local coordination in a multicenter randomized controlled trial: the FAITH trial experience
Zielinski, et al. (2012)