Comparison of Clinical and Radiological Outcomes of Four Different Proximal Femoral Nailing Systems in the Treatment of Intertrochanteric Fractures.

PURPOSE OF THE STUDY: This study aimed to compare the clinical and radiological outcomes of four different proximal femoral nailing systems-Proximal Femoral Nail Antirotation (PFNA), Dynamic Locked Trochanteric (DLT) nail, Intertan, and Talon Distalfix-used in the surgical treatment of intertrochanteric femoral fractures. The goal was to evaluate the differences between systems both statistically and in terms of clinical relevance.

MATERIAL AND

METHODS

A retrospective analysis was conducted on 309 patients who underwent PFN procedures between January 2015 and December 2019. Patients were categorized into four groups based on the type of nail used. Parameters assessed included operative time, intraoperative blood loss, fluoroscopy time, fracture union time, Harris Hip Score, WOMAC score, reduction quality, and complication rates. Additionally, Minimal Clinically Important Difference (MCID) values were calculated to assess the clinical significance of any observed differences.

RESULTS

The Talon Distalfix group demonstrated significantly lower operative time, blood loss, and fluoroscopy duration (all p < 0.001). Since these differences exceeded MCID thresholds, they were considered not only statistically significant but also clinically meaningful. No significant differences were observed among the groups in terms of functional outcomes (Harris Hip Score, WOMAC score), fracture union time, or reduction quality. The overall complication rate was 22.9%, with screw cut-out being the most common complication (14.2%). Complication rates did not differ significantly between the groups.

CONCLUSIONS

The Talon Distalfix nail was found to offer both statistically and clinically significant advantages in terms of shorter operative time, reduced blood loss, and less fluoroscopy exposure. While functional outcomes and complication rates were similar across all groups, the findings suggest that implant design may play a decisive role in intraoperative parameters.