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Improving Screw Fixation In Hip Fracture

Posted on: 11/30/1999
Hip fracture can be a devastating injury in the older adult. Osteoporosis or brittle bones makes bones more likely to break. Trying to repair a broken hip by using pins or screws to hold it in place can be difficult when the bone is osteoporotic.

There is a class of medication called bisphosphonates that can help improve bone strength. In this study, surgeons from Italy tested the idea that screw fixation could be improved by having patients with hip fractures take bisphosphonates.

Women 65 years old and older with a hip fracture were divided into two groups. All patients were treated with surgery (pin fixation) within 48 hours of the injury. Group A was given an oral bisphosphonate (alendronate, also known as Fosamax) for three months after the fracture. Group B did not receive the drug.

X-rays were used to show the position of the screws and the condition of the bone around the hardware. Fixation strength was also measured using an extraction torque gauge. This tool gives the surgeon an idea of how much force it would take to pull the pin out of the bone.

The results showed that in Group A, the extraction torque improved over time. In Group B the extraction torque remained the same. The authors concluded there was a positive effect of alendronate on screw fixation for osteoporotic patients with a hip fracture.

Antonio Moroni, MD, et al. Alendronate Improves Screw Fixation in Osteoporotic Bone. In The Journal of Bone and Joint Surgery. January 2007. Vol. 89-A. No. 1. Pp. 96-101.

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