Biomechanical studies:
Stronger fixation, rotationally stable
X-Bolt superior and more forgiving in static and cyclic testing.
Clinical studies:
WHiTE One : RCT in (high-risk) unstable A2 and A3 fractures
Dementia patients able to be included (unlike most in literature)
0% cut-out for X-Bolt, 6% for SHS screw
Better 4-week EQ5D scores for X-Bolt
WHiTE Four: largest ever hip fracture fixation RCT
0.8% cut-out rate for X-Bolt (lowest-ever cut-out rate in any large hip# RCT)
Data issues with WHiTE Four include 11% crossovers (randomized to XHS but received SHS), 5% 'treatment unknown', Baseline frailty not adjusted for, Missing reoperation data for SHS cohort