Extracapsular hip fractures: fixation with a twin hook or a lag screw?

The twin hook, which has 2 oppositely directed apical hooks, is an alternative to the lag screw for use with a 'dynamic plate' in the fixation of trochanteric hip fractures. In this prospective study lasting 1 year, 102 consecutive patients with trochanteric hip fractures were treated by 19 surgeons with either a twin hook or a lag screw combined with a conventional sliding hip screw plate or a Medoff sliding plate. Seven intraoperative errors were made with the twin hook but postoperative migration did not differ significantly between the 2 groups. Postoperative fixation failures were equally distributed between the 2 groups. The twin hook provides adequate fixation, which is comparable to that produced by a lag screw.