Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2025
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.
СтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Arı Bünyamin, Yükünç İsmail
Аннотация
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.
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.