Instability of trochanteric hip fractures following internal fixation. A radiographic comparison of the Richards sliding screw-plate and the McLaughlin nail-plate.

A comparison was made of the McLaughlin nail plate and the Richards sliding screw-plate techniques for fixation of trochanteric hip fractures. The series included 96 patients in each group. The fractures were followed radiographically for 3 months. Technical failures were encountered in 31 per cent of the McLaughlin fractures and in 8 per cent of the Richards fractures; reoperation was performed in 9 per cent in McLaughlin vs none in the Richards fractures. The main failure was varus displacement in both groups, always combined with lateral cutting of the screw in the Richards fractures, and often combined with failure of the nail-plate junction in McLaughlin fractures. Our study has shown that the sliding screw-plate is superior to the nail plate in both stable and unstable fractures.