Warwick Hip Trauma Evaluation One

INTERVENTION: Intervention: X Bolt Dynamic Plating System Control: Sliding Hip Screw Average time taken per intervention/procedure: Sliding hip screw fixation: 75 minutes X‐Blot dynamic plating system fixation: 75 minutes Unstable trochanteric fractures (AO / OTA type A2/A3) are treated with fixation of the fracture in nearly all cases. This type of fracture is very unstable and as a result has a high incidence of complications, failure of fixation and reoperation. The standard care for many years was the sliding hip screw which is successful in many cases. However, in some patients it does not offer enough stability for the fracture to heal, commonly the screws cut out of the femoral head necessitating revision surgery. The X‐Bolt dynamic plating system builds on the successful features of the sliding hip screw but aims to improve the fixation in the head by employing expanding flanges. These flanges compress the soft cellulous bone which is usually present in patients sustaining this type of fracture leading to a more secure fixation. CONDITION: Proximal femoral fractures ; Injury, Occupational Diseases, Poisoning ; Fracture of femur PRIMARY OUTCOME: Observed differences in the EQ‐5D score between the trial treatment goups at one year post‐injury SECONDARY OUTCOME: 1. Observed differences in the proportion of all cause revision surgery between trial treatment groups; 2. Observed differences in the proportion of complications between the trial treatment groups INCLUSION CRITERIA: All patients (> 65 years, either sex) both with and without capacity, presenting to the University Hospitals Coventry and Warwickshire NHS Trust with an AO/OTA A2 and A3 fracture of the proximal femur