ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1642909
Comparison of proximal femoral universal nail and proximal femoral nail anti-rotation internal fixation for older patients with intertrochanteric femoral fracture: a retrospective cohort study
Provisionally accepted
- Peking University Third Hospital, Haidian, China
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Introduction: Intertrochanteric femoral fractures (IFF) are among the most common lower limb fractures in the older population. Our team has developed a new cephalomedullary nail design called the proximal femoral universal nail (PFUN). This study aimed to compare the clinical outcomes of PFUN and proximal femoral nail anti-rotation (PFNA) internal fixation for the treatment of IFF in older patients. Methods: We retrospectively reviewed the clinical records of 435 older patients with IFF who were treated at Peking University Third Hospital between January 2022 and January 2024. Among them, 215 underwent PFUN (PFUN group) and 220 underwent PFNA (PFNA group) internal fixation. Demographic data, operation time, hospitalisation time, blood loss, intraoperative transfusion, complications, Harris hip scores (HHS), and Parker-Palmer mobility scores (PPMS) were compared between the two groups. Results: The two groups were comparable in terms of demographic data (P>0.05). The operation time in the PFNA group was shorter than that in the PFUN group, and blood loss was less than that in the PFUN group (P<0.05). However, the hospitalisation time was shorter in the PFUN group than in the PFNA group (P<0.05). At 3 and 6 months postoperatively, the HHSs of the PFUN group were significantly higher than those of the PFNA group, and similar results were obtained for PPMS at 6 months postoperatively (P<0.05). The rate of fixation failure in the PFUN group was significantly lower than that in the other groups (P<0.05), . Among patients with 31-A2, the implant failure rate in PFUN group was significantly lower than that in the other group, and the PPMS score at 6 months postoperatively was higher (P < 0.05). In the 31-A3 stratification, the Harris and PPMS of the PFUN group during the postoperative follow-up period were higher than those of the PFNA group (P < 0.05). Conclusions:The PFUN is an effective and safe internal fixation device for IFFs, especially for unstable medial and lateral wall fractures. Compared to PFNA, PFUN can significantly reduce the rate of implant failure in IFFs and accelerate postoperative rehabilitation. For IFFs with AO/OTA classifications of 31-A2 and A3, PFUN has a greater advantage than PFNA.
Keywords: Intertrochanteric femoral fractures, proximal femoral universal nail, Proximal femoral nail anti-rotation, fixation failure, medial and lateral wall fractures
Received: 07 Jun 2025; Accepted: 31 Jul 2025.
Copyright: © 2025 Cao, Fan, Cui, Hao, Lv, Tian, Lv and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yang Lv, Peking University Third Hospital, Haidian, China
Yang Lv, Peking University Third Hospital, Haidian, China
Fang Zhou, Peking University Third Hospital, Haidian, China
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