Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) Investigators

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between March 3, 2008, and March 31, 2014, we randomly assigned 1108 patients to receive a sliding hip screw (n=557) or cancellous screws (n=551). Reoperations within 24 months did not differ by type of surgical fixation in those included in the primary analysis: 107 (20%) of 542 patients in the sliding hip screw group versus 117 (22%) of 537 patients in the cancellous screws group (hazard ratio [HR] 0·83, 95% CI 0·63–1·09; p=0·18). Avascular necrosis was more common in the sliding hip screw group than in the cancellous screws group (50 patients [9%] vs 28 patients [5%]; HR 1·91, 1·06–3·44; p=0·0319). However, no significant difference was found between the number of medically related adverse events between groups (p=0·82; appendix); these events included pulmonary embolism (two patients [<1%] vs four [1%] patients; p=0·41) and sepsis (seven [1%] vs six [1%]; p=0·79). Interpretation In terms of reoperation rates the sliding hip screw shows no advantage, but some groups of patients (smokers and those with displaced or base of neck fractures) might do better with a sliding hip screw than with cancellous screws. Funding National Institutes of Health, Canadian Institutes of Health Research, Stichting NutsOhra, Netherlands Organisation for Health Research and Development, Physicians' Services Incorporated.

Original languageEnglish
Pages (from-to)1519-1527
Number of pages9
JournalThe Lancet
Volume389
Issue number10078
DOIs
Publication statusPublished - 15 Apr 2017
Externally publishedYes

Cite this

Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) Investigators (2017). Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial. The Lancet, 389(10078), 1519-1527. https://doi.org/10.1016/S0140-6736(17)30066-1
Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) Investigators. / Fracture fixation in the operative management of hip fractures (FAITH) : an international, multicentre, randomised controlled trial. In: The Lancet. 2017 ; Vol. 389, No. 10078. pp. 1519-1527.
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title = "Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial",
abstract = "Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between March 3, 2008, and March 31, 2014, we randomly assigned 1108 patients to receive a sliding hip screw (n=557) or cancellous screws (n=551). Reoperations within 24 months did not differ by type of surgical fixation in those included in the primary analysis: 107 (20{\%}) of 542 patients in the sliding hip screw group versus 117 (22{\%}) of 537 patients in the cancellous screws group (hazard ratio [HR] 0·83, 95{\%} CI 0·63–1·09; p=0·18). Avascular necrosis was more common in the sliding hip screw group than in the cancellous screws group (50 patients [9{\%}] vs 28 patients [5{\%}]; HR 1·91, 1·06–3·44; p=0·0319). However, no significant difference was found between the number of medically related adverse events between groups (p=0·82; appendix); these events included pulmonary embolism (two patients [<1{\%}] vs four [1{\%}] patients; p=0·41) and sepsis (seven [1{\%}] vs six [1{\%}]; p=0·79). Interpretation In terms of reoperation rates the sliding hip screw shows no advantage, but some groups of patients (smokers and those with displaced or base of neck fractures) might do better with a sliding hip screw than with cancellous screws. Funding National Institutes of Health, Canadian Institutes of Health Research, Stichting NutsOhra, Netherlands Organisation for Health Research and Development, Physicians' Services Incorporated.",
author = "Aaron Nauth and Creek, {Aaron T.} and Abby Zellar and Lawendy, {Abdel Rahman} and Adam Dowrick and Ajay Gupta and Akhil Dadi and {van Kampen}, Albert and Albert Yee and {de Vries}, {Alexander C.} and {de Mol van Otterloo}, Alexander and Alisha Garibaldi and Allen Liew and McIntyre, {Allison W.} and Prasad, {Amal Shankar} and Romero, {Amanda W.} and Amar Rangan and Amber Oatt and Amir Sanghavi and Foley, {Amy L.} and Anders Karlsten and Andrea Dolenc and Andrew Bucknill and Andrew Chia and Andrew Evans and Andrew Gong and Schmidt, {Andrew H.} and Marcantonio, {Andrew J.} and Andrew Jennings and Angela Ward and Angshuman Khanna and Anil Rai and Smits, {Anke B.} and Horan, {Annamarie D.} and Brekke, {Anne Christine} and Annette Flynn and Aravin Duraikannan and Are St{\o}dle and {van Vugt}, {Arie B.} and Arlene Luther and Zurcher, {Arthur W.} and Arvind Jain and Asgeir Amundsen and Ash Moaveni and Ashley Carr and Ateet Sharma and Hill, {Austin D.} and Axel Trommer and Rai, {B. Sachidananda} and Barbara Hileman and Bart Schreurs and Bart Verhoeven and Barden, {Benjamin B.} and Bernhard Flat{\o}y and Cleffken, {Berry I.} and Berthe B{\o}e and Bertrand Perey and Hanusch, {Birgit C.} and Brad Weening and Bram Fioole and Bram Rijbroek and Crist, {Brett D.} and Brett Halliday and Brett Peterson and Brian Mullis and Richardson, {C. Glen} and Callum Clark and Sagebien, {Carlos A.} and {van der Pol}, {Carmen C.} and Carol Bowler and Humphrey, {Catherine A.} and Catherine Coady and Koppert, {Cees L.} and Chad Coles and Chadi Tannoury and DePaolo, {Charles J.} and Chris Gayton and Chris Herriott and Christina Reeves and Christina Tieszer and Christine Dobb and Anderson, {Christopher G.} and Claire Sage and Claudine Cuento and Jones, {Clifford B.} and Bosman, {Coks H.R.} and Colleen Linehan and {van der Hart}, {Cor P.} and Corey Henderson and Lewis, {Courtland G.} and Davis, {Craig A.} and Craig Donohue and Cyril Mauffrey and Sundaresh, {D. C.} and Farrell, {Dana J.} and Whelan, {Daniel B.} and Daniel Horwitz and Daniel Stinner and Darius Viskontas and Roffey, {Darren M.} and David Alexander and Karges, {David E.} and David Hak and David Johnston and David Love and Wright, {David M.} and Zamorano, {David P.} and Goetz, {David R.} and David Sanders and David Stephen and David Yen and Davide Bardana and Olakkengil, {Davy J.} and Deanna Lawson and Deborah Maddock and Sietsema, {Debra L.} and Deeba Pourmand and {Den Hartog}, Dennis and Derek Donegan and Diane Heels-Ansdell and Diane Nam and Dominic Inman and Dory Boyer and Doug Li and Douglas Gibula and Price, {Dustin M.} and Watson, {Dylan J.} and Hammerberg, {E. Mark} and Tan, {Edward T.C.H.} and {de Graaf}, {Eelco J.R.} and Vesterhus, {Elise Berg} and Elizabeth Roper and Elton Edwards and Schemitsch, {Emil H.} and Hammacher, {Eric R.} and Henderson, {Eric R.} and Erica Whatley and Torres, {Erick T.} and Vermeulen, {Erik G.J.} and Erin Finn and {Van Lieshout}, {Esther M.M.} and Wai, {Eugene K.} and Bannister, {Evan R.} and Evelyn Kile and Theunissen, {Evert B.M.} and Ritchie, {Ewan D.} and Farah Khan and Farhad Moola and Fiona Howells and {de Nies}, Frank and {van der Heijden}, {Frank H.W.M.} and {de Meulemeester}, {Frank R.A.J.} and Frede Frihagen and Fredrik Nilsen and Schmidt, {G. Ben} and Albers, {G. H.Robert} and Gudger, {Garland K.} and Garth Johnson and Gary Gruen and Gary Zohman and Gaurav Sharma and Gavin Wood and Tetteroo, {Geert W.M.} and Geir Hjorthaug and Geir Jomaas and Geoff Donald and Rieser, {Geoffrey Ryan} and Gerald Reardon and Slobogean, {Gerard P.} and Roukema, {Gert R.} and Visser, {Gijs A.} and Gilbert Moatshe and Gillian Horner and Glynis Rose and Gordon Guyatt and Graham Chuter and Greg Etherington and Rocca, {Gregory J.Della} and Guri Ek{\aa}s and Gwendolyn Dobbin and Lemke, {H. Michael} and Hamish Curry and Han Boxma and Hannah Gissel and Hans Kreder and Hans Kuiken and Brom, {Hans L.F.} and Pape, {Hans Christoph} and {van der Vis}, {Harm M.} and Harvinder Bedi and Vallier, {Heather A.} and Heather Brien and Heather Silva and Heike Newman and Helena Viveiros and {van der Hoeven}, Henk and Henry Ahn and Herman Johal and Herman Rijna and Heyn Stockmann and Josaputra, {Hong A.} and Hope Carlisle and {van der Brand}, Igor and Imro Dawson and Ivan Tarkin and Ivan Wong and Parr, {J. Andrew} and Trenholm, {J. Andrew} and Goslings, {J. Carel} and Amirault, {J. David} and Broderick, {J. Scott} and Snellen, {Jaap P.} and Zijl, {Jacco A.C.} and Jaimo Ahn and James Ficke and James Irrgang and James Powell and Ringler, {James R.} and James Shaer and Monica, {James T.} and Jan Biert and Jan Bosma and Brattgjerd, {Jan Egil} and Fr{\"o}lke, {Jan Paul M.} and Jan Wille and Janakiraman Rajakumar and Walker, {Jane E.} and Baker, {Janell K.} and Ertl, {Janos P.} and {de Vries}, {Jean Paul P.M.} and Gardeniers, {Jean W.M.} and Jedediah May and Jeff Yach and Hidy, {Jennifer T.} and Westberg, {Jerald R.} and Hall, {Jeremy A.} and {van Mulken}, Jeroen and McBeth, {Jessica Cooper} and Jochem Hoogendoorn and Hoffman, {Jodi M.} and Cherian, {Joe Joseph} and Tanksley, {John A.} and John Clarke-Jenssen and Adams, {John D.} and John Esterhai and Tilzey, {John F.} and John Murnaghan and Ketz, {John P.} and Max Esser and Susan Liew and {Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) Investigators}",
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Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) Investigators 2017, 'Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial' The Lancet, vol. 389, no. 10078, pp. 1519-1527. https://doi.org/10.1016/S0140-6736(17)30066-1

Fracture fixation in the operative management of hip fractures (FAITH) : an international, multicentre, randomised controlled trial. / Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) Investigators.

In: The Lancet, Vol. 389, No. 10078, 15.04.2017, p. 1519-1527.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Fracture fixation in the operative management of hip fractures (FAITH)

T2 - an international, multicentre, randomised controlled trial

AU - Nauth, Aaron

AU - Creek, Aaron T.

AU - Zellar, Abby

AU - Lawendy, Abdel Rahman

AU - Dowrick, Adam

AU - Gupta, Ajay

AU - Dadi, Akhil

AU - van Kampen, Albert

AU - Yee, Albert

AU - de Vries, Alexander C.

AU - de Mol van Otterloo, Alexander

AU - Garibaldi, Alisha

AU - Liew, Allen

AU - McIntyre, Allison W.

AU - Prasad, Amal Shankar

AU - Romero, Amanda W.

AU - Rangan, Amar

AU - Oatt, Amber

AU - Sanghavi, Amir

AU - Foley, Amy L.

AU - Karlsten, Anders

AU - Dolenc, Andrea

AU - Bucknill, Andrew

AU - Chia, Andrew

AU - Evans, Andrew

AU - Gong, Andrew

AU - Schmidt, Andrew H.

AU - Marcantonio, Andrew J.

AU - Jennings, Andrew

AU - Ward, Angela

AU - Khanna, Angshuman

AU - Rai, Anil

AU - Smits, Anke B.

AU - Horan, Annamarie D.

AU - Brekke, Anne Christine

AU - Flynn, Annette

AU - Duraikannan, Aravin

AU - Stødle, Are

AU - van Vugt, Arie B.

AU - Luther, Arlene

AU - Zurcher, Arthur W.

AU - Jain, Arvind

AU - Amundsen, Asgeir

AU - Moaveni, Ash

AU - Carr, Ashley

AU - Sharma, Ateet

AU - Hill, Austin D.

AU - Trommer, Axel

AU - Rai, B. Sachidananda

AU - Hileman, Barbara

AU - Schreurs, Bart

AU - Verhoeven, Bart

AU - Barden, Benjamin B.

AU - Flatøy, Bernhard

AU - Cleffken, Berry I.

AU - Bøe, Berthe

AU - Perey, Bertrand

AU - Hanusch, Birgit C.

AU - Weening, Brad

AU - Fioole, Bram

AU - Rijbroek, Bram

AU - Crist, Brett D.

AU - Halliday, Brett

AU - Peterson, Brett

AU - Mullis, Brian

AU - Richardson, C. Glen

AU - Clark, Callum

AU - Sagebien, Carlos A.

AU - van der Pol, Carmen C.

AU - Bowler, Carol

AU - Humphrey, Catherine A.

AU - Coady, Catherine

AU - Koppert, Cees L.

AU - Coles, Chad

AU - Tannoury, Chadi

AU - DePaolo, Charles J.

AU - Gayton, Chris

AU - Herriott, Chris

AU - Reeves, Christina

AU - Tieszer, Christina

AU - Dobb, Christine

AU - Anderson, Christopher G.

AU - Sage, Claire

AU - Cuento, Claudine

AU - Jones, Clifford B.

AU - Bosman, Coks H.R.

AU - Linehan, Colleen

AU - van der Hart, Cor P.

AU - Henderson, Corey

AU - Lewis, Courtland G.

AU - Davis, Craig A.

AU - Donohue, Craig

AU - Mauffrey, Cyril

AU - Sundaresh, D. C.

AU - Farrell, Dana J.

AU - Whelan, Daniel B.

AU - Horwitz, Daniel

AU - Stinner, Daniel

AU - Viskontas, Darius

AU - Roffey, Darren M.

AU - Alexander, David

AU - Karges, David E.

AU - Hak, David

AU - Johnston, David

AU - Love, David

AU - Wright, David M.

AU - Zamorano, David P.

AU - Goetz, David R.

AU - Sanders, David

AU - Stephen, David

AU - Yen, David

AU - Bardana, Davide

AU - Olakkengil, Davy J.

AU - Lawson, Deanna

AU - Maddock, Deborah

AU - Sietsema, Debra L.

AU - Pourmand, Deeba

AU - Den Hartog, Dennis

AU - Donegan, Derek

AU - Heels-Ansdell, Diane

AU - Nam, Diane

AU - Inman, Dominic

AU - Boyer, Dory

AU - Li, Doug

AU - Gibula, Douglas

AU - Price, Dustin M.

AU - Watson, Dylan J.

AU - Hammerberg, E. Mark

AU - Tan, Edward T.C.H.

AU - de Graaf, Eelco J.R.

AU - Vesterhus, Elise Berg

AU - Roper, Elizabeth

AU - Edwards, Elton

AU - Schemitsch, Emil H.

AU - Hammacher, Eric R.

AU - Henderson, Eric R.

AU - Whatley, Erica

AU - Torres, Erick T.

AU - Vermeulen, Erik G.J.

AU - Finn, Erin

AU - Van Lieshout, Esther M.M.

AU - Wai, Eugene K.

AU - Bannister, Evan R.

AU - Kile, Evelyn

AU - Theunissen, Evert B.M.

AU - Ritchie, Ewan D.

AU - Khan, Farah

AU - Moola, Farhad

AU - Howells, Fiona

AU - de Nies, Frank

AU - van der Heijden, Frank H.W.M.

AU - de Meulemeester, Frank R.A.J.

AU - Frihagen, Frede

AU - Nilsen, Fredrik

AU - Schmidt, G. Ben

AU - Albers, G. H.Robert

AU - Gudger, Garland K.

AU - Johnson, Garth

AU - Gruen, Gary

AU - Zohman, Gary

AU - Sharma, Gaurav

AU - Wood, Gavin

AU - Tetteroo, Geert W.M.

AU - Hjorthaug, Geir

AU - Jomaas, Geir

AU - Donald, Geoff

AU - Rieser, Geoffrey Ryan

AU - Reardon, Gerald

AU - Slobogean, Gerard P.

AU - Roukema, Gert R.

AU - Visser, Gijs A.

AU - Moatshe, Gilbert

AU - Horner, Gillian

AU - Rose, Glynis

AU - Guyatt, Gordon

AU - Chuter, Graham

AU - Etherington, Greg

AU - Rocca, Gregory J.Della

AU - Ekås, Guri

AU - Dobbin, Gwendolyn

AU - Lemke, H. Michael

AU - Curry, Hamish

AU - Boxma, Han

AU - Gissel, Hannah

AU - Kreder, Hans

AU - Kuiken, Hans

AU - Brom, Hans L.F.

AU - Pape, Hans Christoph

AU - van der Vis, Harm M.

AU - Bedi, Harvinder

AU - Vallier, Heather A.

AU - Brien, Heather

AU - Silva, Heather

AU - Newman, Heike

AU - Viveiros, Helena

AU - van der Hoeven, Henk

AU - Ahn, Henry

AU - Johal, Herman

AU - Rijna, Herman

AU - Stockmann, Heyn

AU - Josaputra, Hong A.

AU - Carlisle, Hope

AU - van der Brand, Igor

AU - Dawson, Imro

AU - Tarkin, Ivan

AU - Wong, Ivan

AU - Parr, J. Andrew

AU - Trenholm, J. Andrew

AU - Goslings, J. Carel

AU - Amirault, J. David

AU - Broderick, J. Scott

AU - Snellen, Jaap P.

AU - Zijl, Jacco A.C.

AU - Ahn, Jaimo

AU - Ficke, James

AU - Irrgang, James

AU - Powell, James

AU - Ringler, James R.

AU - Shaer, James

AU - Monica, James T.

AU - Biert, Jan

AU - Bosma, Jan

AU - Brattgjerd, Jan Egil

AU - Frölke, Jan Paul M.

AU - Wille, Jan

AU - Rajakumar, Janakiraman

AU - Walker, Jane E.

AU - Baker, Janell K.

AU - Ertl, Janos P.

AU - de Vries, Jean Paul P.M.

AU - Gardeniers, Jean W.M.

AU - May, Jedediah

AU - Yach, Jeff

AU - Hidy, Jennifer T.

AU - Westberg, Jerald R.

AU - Hall, Jeremy A.

AU - van Mulken, Jeroen

AU - McBeth, Jessica Cooper

AU - Hoogendoorn, Jochem

AU - Hoffman, Jodi M.

AU - Cherian, Joe Joseph

AU - Tanksley, John A.

AU - Clarke-Jenssen, John

AU - Adams, John D.

AU - Esterhai, John

AU - Tilzey, John F.

AU - Murnaghan, John

AU - Ketz, John P.

AU - Esser, Max

AU - Liew, Susan

AU - Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) Investigators

PY - 2017/4/15

Y1 - 2017/4/15

N2 - Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between March 3, 2008, and March 31, 2014, we randomly assigned 1108 patients to receive a sliding hip screw (n=557) or cancellous screws (n=551). Reoperations within 24 months did not differ by type of surgical fixation in those included in the primary analysis: 107 (20%) of 542 patients in the sliding hip screw group versus 117 (22%) of 537 patients in the cancellous screws group (hazard ratio [HR] 0·83, 95% CI 0·63–1·09; p=0·18). Avascular necrosis was more common in the sliding hip screw group than in the cancellous screws group (50 patients [9%] vs 28 patients [5%]; HR 1·91, 1·06–3·44; p=0·0319). However, no significant difference was found between the number of medically related adverse events between groups (p=0·82; appendix); these events included pulmonary embolism (two patients [<1%] vs four [1%] patients; p=0·41) and sepsis (seven [1%] vs six [1%]; p=0·79). Interpretation In terms of reoperation rates the sliding hip screw shows no advantage, but some groups of patients (smokers and those with displaced or base of neck fractures) might do better with a sliding hip screw than with cancellous screws. Funding National Institutes of Health, Canadian Institutes of Health Research, Stichting NutsOhra, Netherlands Organisation for Health Research and Development, Physicians' Services Incorporated.

AB - Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between March 3, 2008, and March 31, 2014, we randomly assigned 1108 patients to receive a sliding hip screw (n=557) or cancellous screws (n=551). Reoperations within 24 months did not differ by type of surgical fixation in those included in the primary analysis: 107 (20%) of 542 patients in the sliding hip screw group versus 117 (22%) of 537 patients in the cancellous screws group (hazard ratio [HR] 0·83, 95% CI 0·63–1·09; p=0·18). Avascular necrosis was more common in the sliding hip screw group than in the cancellous screws group (50 patients [9%] vs 28 patients [5%]; HR 1·91, 1·06–3·44; p=0·0319). However, no significant difference was found between the number of medically related adverse events between groups (p=0·82; appendix); these events included pulmonary embolism (two patients [<1%] vs four [1%] patients; p=0·41) and sepsis (seven [1%] vs six [1%]; p=0·79). Interpretation In terms of reoperation rates the sliding hip screw shows no advantage, but some groups of patients (smokers and those with displaced or base of neck fractures) might do better with a sliding hip screw than with cancellous screws. Funding National Institutes of Health, Canadian Institutes of Health Research, Stichting NutsOhra, Netherlands Organisation for Health Research and Development, Physicians' Services Incorporated.

UR - http://www.scopus.com/inward/record.url?scp=85014150802&partnerID=8YFLogxK

U2 - 10.1016/S0140-6736(17)30066-1

DO - 10.1016/S0140-6736(17)30066-1

M3 - Article

VL - 389

SP - 1519

EP - 1527

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 10078

ER -

Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) Investigators. Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial. The Lancet. 2017 Apr 15;389(10078):1519-1527. https://doi.org/10.1016/S0140-6736(17)30066-1