Comparison of clinical outcomes of patients treated with proximal femoral nail and proximal femoral anatomic plate in upper-end fractures of the femur - A multicenter study

Sep 30, 2026

Multicenter retrospective research compares proximal femoral nail (PFN) and proximal femoral anatomic plate (PFA) for upper-end proximal femoral fractures, aiming to identify the more advantageous approach for specific patient groups. Between 2016 and 2021, 106 patients (AO/OTA 31A1 and 31A2) were evaluated using Oxford Hip Score, time to surgery, operation time, hospital stay, blood loss, and follow-up duration. Analyses used chi-square, independent t-test, and Mann-Whitney U tests. Results show PFN with shorter operation time, less blood loss, shorter hospitalization, and higher Oxford Hip Score, with no follow-up duration difference.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Abstract

Introduction

Fracture classification and clinical relevance

Fixation methods: PFN and PFA

Methods

Results

Conclusion

ORIGINAL ARTICLE Comparison of clinical outcomes of patients treated with proximal femoral nail and proximal femoral anatomic plate in upper-end fractures ofthe femur: A multicenter study Bünyamin Arı,1 İsmail Yükünç2 1Department of Orthopedics and Traumatology, Kütahya Health Sciences University Faculty of Medicine, Kütahya-Türkiye 2Department of Orthopaedics and Traumatology, Haçkalı Baba Public Hospital, Trabzon-Türkiye ABSTRACT BACKGROUND: The aim of this study is to compare the clinical results of proximal femoral nail (PFN) and proximal femoral anatomic plate (PFA) methods used in the treatment of proximal femoral fractures through a multicenter retrospective review, and to determine which method is more advantageous for specific patient groups. The study aims to evaluate the effectiveness of PFN and PFA techniques and presents findings that can guide clinical decision-making by revealing the differences between these two methods. METHODS: Between 2016 and 2021, 106 patients with proximal femur fractures classified as type 31A1 and 31A2 according to the AO/OTA (the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association) classification system were retrospectively examined. Patients were treated with either PFN or PFA, and the clinical results were compared. The variables evaluated included Oxford Hip Score, time to surgery, operation time, hospital stay, blood loss, and follow-up duration. Statistical analyses were performed using the chi-square test, independent-samples t-test, and Mann-Whitney U test. RESULTS: When the clinical outcomes of patients treated with PFN and PFA were compared, the PFN group had shorter operation time and less blood loss than the PFA group, and this difference was statistically significant (p<0.05). In addition, hospital stay was shorter in the PFN group, also showing a statistically significant difference (p<0.05). No significant difference was found between the two groups regarding follow-up duration (p>0.05). However, the Oxford Hip Score was higher in the PFN group compared to the PFA group, indicating better postoperative functional results (p<0.05). Analyses by age and comorbidities showed no statistically significant differences between the groups (p>0.05). CONCLUSION: Patients who underwent PFN had advantages such as shorter surgical time, less blood loss, and shorter hospital stay compared to patients who underwent PFA. In this context, PFN can be considered superior in terms of clinical outcomes, as it is less invasive and allows faster recovery. However, no significant difference was observed in follow-up duration. Keywords: Femur fracture; hip fracture; proximal femoral nail; proximal femoral anatomic plate. INTRODUCTION Proximal femur fractures, particularly intertrochanteric AO/ OTA (the Arbeitsgemeinschaft für Osteosynthesefragen/ Orthopaedic Trauma Association) 31A1 and 31A2 patterns, are a significant global health concern. They are among the leading causes of morbidity and mortality in elderly patients, resulting in impaired mobility, reduced independence, and a substantial socioeconomic burden. [1-3] The worldwide incidence of hip fractures is expected to rise dramatically, from 2.6 million cases in 2025 to more than 6.2 million by 2050, paralleling population aging.[4,5] | Cite this article as: Arı B, Yükünç İ. Comparison of clinical outcomes of patients treated with proximal femoral nail and proximal femoral anatomic
plate in upper-end fractures ofthe femur: A multicenter study. Ulus Travma Acil Cerrahi Derg 2025;31:1047-1054.
Address for correspondence: Bünyamin Arı
Department of Orthopedics and Traumatology, Kütahya Health Sciences University Faculty of Medicine, Kütahya, Türkiye
E-mail: [drbunyaminari@hotmail.com](drbunyaminari@hotmail.com) | | | --- | --- | | Ulus Travma Acil Cerrahi Derg 2025;31(10):1047-1054 DOI: 10.14744/tjtes.2025.17676 Submitted: 16.05.2024 Revised: 28.08.2025 Accepted: 01.09.2025 Publish

FAQs

What is the primary goal of the multicenter study comparing PFN and PFA?

To compare clinical results of PFN versus PFA in proximal femoral fractures and determine which method is more advantageous for particular patient groups.

Which clinical outcomes favored PFN over PFA in the study results?

PFN showed shorter operation time, less blood loss, shorter hospital stay, and a higher Oxford Hip Score than PFA.

Did the study find any difference between PFN and PFA in follow-up duration?

No. Follow-up duration did not differ significantly between the two groups.

Sep 30, 2026

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