X-BOLT®Expanding Bolt Osteosynthesisfor the Proximal Femur

40% treated with hemi/THR

40% treated with DHS

20% treated with hip nail

70,000 hips fractures p.a. in UK

£10,000Average in-patient cost per patient episode

The problem of ‘Cut-Out’

0% 2% 4% 6% 8% 10% 12% 14%0

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2008 Cochrane Review: DHS ‘cut-out’ rates

Sample Size 4% Average

‘Cut-Out’ Rate

DHS ‘cut-out’ rate

DHS ‘cut-out’ rates by year of publication

1990-1994 1995-1999 2000-2004 2005-20060.0%

1.0%

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4% ‘Cut-Out’ rate 1600 Patients affected per year in UK

£40M Additional care costs

Economic Impact of ‘Cut-Out’

• 60% larger frontal load area• Strong, secure fixation • Rotationally stable• One shot (centre-centre) fixation • Dynamic sliding compression• Reversible & removable

Get your (femoral) head fixed right

Perpendicular Expansion = No Disruption

Perpendicular Expansion = No Disruption

Perpendicular Expansion = No Disruption

Compacts bone = better stability

‘Tip-Apex’ distance

Tip-Apex Distance (combined >25mm) is a major factor in predicting cut-outBaumgaertner et al. JBJS Am 1995; 77:1058-64

‘Tip-Apex’ fixation maintained

‘Tip-Apex’ fixation maintained

‘Tip-Apex’ fixation maintained

Best bone quality & trabecular lines

Snug fit in drill-hole

Not so snug

Biomechanical testing vs. DHS Screw

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ad (N

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Displacement (mm)

Push-out test for DHS lag screwin synthetic bone

Load

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Displacement (mm)

Push-out test for X-BOLTin synthetic bone

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X-BOLT®Dynamic Hip PlatingSurgical Technique

X-BOLT®Expanding Bolt Osteosynthesisfor the Proximal Femur

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