Use of the talon hip compression screw in intertrochanteric fractures of the hip.

A retrospective analysis of a compression hip screw with four reversibly deployable talons was done. Fifty-four patients had sufficient radiographs to be included in this analysis. One-year mortality was 17% and increased to 41% by 2 years. No lag screws cut out, and postoperative slide was reduced compared with that in many published series. Three patients had revision of a failed alternate-type hip pin with the Talon hip compression screw. Previous studies showed the talons provide the definitive difference in allowing enhanced compression at the time of surgery, preventing cut-out by enhanced rotational stability, and allowing immediate postoperative weightbearing without excessive limb shortening. The failure mode of the Talon compression hip screw seems to be side-plate loosening rather than varus deformity and lag screw cut-out. The Talon compression hip screw especially is effective with weak, osteoporotic bone and in unstable, three-part and four-part fractures. A previous study showed that Talon deployment notably improved interfragment compression and torsional strength, and that engagement or penetration into or through the cortical bone at the base of the femoral head-neck junction in the inferior lag screw position was the critical technical step to maximize the talon lag screw purchase.