An unusual failure of a sliding hip screw in the immediate post-operative period

Abstract

The sliding hip screw device (SHSD) is a commonly used implant to treat extracapsular neck of femur fractures. The most common described mode of failure is femoral head screw cut out. Mechanical failure is rare and when it occurs normally involves the plate rather that the sliding hip screw. Failure of the sliding hip screw itself is the most uncommon mode of failure and few cases have been reported in the literature. The mode of mechanical failure is usually multiple-cycle, low stress fatigue failure rather than low-cycle, high stress failure as a result of nonunion of the fracture. This case demonstrates a low cycle, high stress failure of the SHS and some of the potential causes for this are discussed.