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Bone Joint Res. 2013 Oct 2;2(10):206-9. doi: 10.1302/2046-3758.210.2000183. Print 2013.

The Warwick Hip Trauma Evaluation One -an abridged protocol for the WHiTE One Study: An embedded randomised trial comparing the X-bolt with slidinghip screw fixation in extracapsular hip fractures.

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Warwick Orthopaedics, Warwick MedicalSchool, University of Warwick, CoventryCV4 7AL, UK, and UniversityHospitals Coventry and Warwickshire NHS Trust, CliffordBridge Road, Coventry CV2 2DX, UK.


Fractures of the proximal femur are one of the greatest challenges facing the medical community, constituting a heavy socioeconomic burden worldwide. Controversy exists regarding the optimal treatment for patients with unstable trochanteric proximal femoral fractures. The recognised treatment alternatives are extramedullary fixation usually with a sliding hip screw and intramedullary fixation with a cephalomedullary nail. Current evidence suggests that best results and lowest complication rates occur using a sliding hip screw. Complications in these difficult fractures are relatively common regardless of type of treatment. We believe that a novel device, the X-Bolt dynamic plating system, may offer superior fixation over a sliding hip screw with lower reoperation risk and better function. We therefore propose to investigate the clinical effectiveness of the X-bolt dynamic plating system compared with standard sliding hip screw fixation within the framework of a the larger WHiTE (Warwick Hip Trauma Evaluation) Comprehensive Cohort Study. Cite this article: Bone Joint Res 2013;2:206-9.


Frail older adults; Hip fractures; Outcome assessment (Health Care); Protocol; RCT; Randomised controlled trial

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