ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2020
PFNA and DHS for AO/OTA 31-A2 fractures: radiographic measurements, morbidity and mortality.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Extramedullary versus intramedullary fixation of unstable trochanteric femoral fractures (AO type 31-A2): a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2024Pooled it
- Cephalo-medullary nailing versus dynamic hip screw with trochanteric stabilisation plate for the treatment of unstable per-trochanteric hip fractures: a meta-analysis.Journal of orthopaedic surgery and research · 2021Pooled it
- [Application of precise-guided temporary fixation assistive devices in proximal femoral nail antirotation fixation for femoral intertrochanteric fractures].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025Trial
- [Trochanteric fixation nail advanced for trochanteric femoral fractures : Central cut-out as a new problem?]Unfallchirurgie (Heidelberg, Germany) · 2026Article
- Perioperative Anemia and Transfusion Management in Older Adults with Osteoporotic Hip Fractures: A Narrative Review of Current Evidence and Emerging Strategies.Clinical interventions in aging · 2026Review
- Finite element analysis of different cephalomedullary nail treatments for basicervical femoral neck fracture.Scientific reports · 2025Article
- Risk factors for implant failure of PFNA-II in the treatment of intertrochanteric fractures (AO/OTA 31 A1 and A2).BMC musculoskeletal disorders · 2025Article
- Comparison of the clinical outcomes between proximal femoral nail anti-rotation with cement enhancement and hemiarthroplasty among elderly osteoporotic patients with intertrochanteric fracture.BMC musculoskeletal disorders · 2024Article
- Angle-Adjustable Dynamic Hip Screw Plate for Unstable Trochanteric Fractures in Middle-Aged Patients: Mid-Term Outcomes and Return to Sport.Journal of clinical medicine · 2024Article
- Comparison of intra-operative outcomes following internal fixation with trochanteric stabilisation plate or intramedullary nail in intertrochanteric fractures.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Is Sliding Compression Necessary for Intramedullary Nailing Fixation of AO/OTA Type A3.3 Intertrochanteric Fracture?Orthopaedic surgery · 2023Article
- Risk Factors Associated with Fixation Failure in Intertrochanteric Fracture Treated with Cephalomedullary Nail.Hip & pelvis · 2023Article
- Proximal femoral bionic nail (PFBN)-an innovative surgical method for unstable femoral intertrochanteric fractures.International orthopaedics · 2023Article
- Biomechanical stability of short versus long proximal femoral nails in osteoporotic subtrochanteric A3 reverse-oblique femoral fractures: a cadaveric study.Archives of orthopaedic and trauma surgery · 2023Article
- Finite-Element Analysis of a Novel Cephalomedullary Nail for Restricted Sliding to Reduce Risk of Implant Failure in Unstable Intertrochanteric Fractures.Orthopaedic surgery · 2022Article
- Comparison of clinical outcomes with proximal femoral nail anti-rotation versus bipolar hemiarthroplasty for the treatment of elderly unstable comminuted intertrochanteric fractures.BMC musculoskeletal disorders · 2022Article
- Trochanteric stabilizing plate in the treatment of trochanteric fractures: a scoping review.Acta orthopaedica · 2021Article
- Inferior Outcome after Unstable Trochanteric Fracture Patterns Compared to Stable Fractures in the Elderly.Journal of clinical medicine · 2021Article
- Evaluation of the quadrants of femoral neck-head in the cephalomedullary fixation of intertrochanteric fractures with a helical blade: Is inferior posterior quadrant also safe? A clinical study.Joint diseases and related surgery · 2021Article
- Sub-Classification of AO/OTA-2018 Pertrochanteric Fractures Is Associated With Clinical Outcomes After Fixation of Intramedullary Nails.Geriatric orthopaedic surgery & rehabilitation · 2021Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeFor this retrospective cohort study, we assessed pertrochanteric fracture types AO/OTA 31-A2. PFNA and DHS were the devices used. We determined both devices in relation to peri-operative variables, postoperative radiographic measurements, implant-related complications and mortality up to 2 years. The null hypothesis was no effect between the two devices.
methodsThis single-centre study was conducted based on our computerized data. The treatment period ranged from 2006 to 2015. Only patients with type AO/OTA 31-A2 fractures and an age ≥ 65 years were included. Apart from descriptive variables, the following measurements were assessed: (1) duration of surgery, (2) blood loss, (3) transfusion, (4) hospitalization, (5) tip-apex distance (TAD), (6) fracture reduction, (7) screw position, (8) implant-related complications, and (9) mortality. The follow-up was 2 years for each living patient. Missing data were evaluated by telephone call.
resultsA total of 375 consecutive patients were enrolled into three groups: (1) 75 patients treated with DHS and antirotation screw (ARS); (2); 100 patients treated with DHS + ARS + TSP (trochanteric stabilization plate); and (3) 200 patients treated with PFNA. Apart from dementia, the descriptive data (e.g., age and BMI) demonstrated no effects between the three groups. Compared to PFNA, DHS with or without TSP was adversely affected by a longer operation time, higher blood loss, increase in transfusion, and more implant-related complications including cut-out, infection and failure. The rate of cut-out was significantly higher in TAD ≥ 25 mm (p = 0.005), and PFNA demonstrated significantly better TAD measurements (p = 0.001), better fracture reduction (0.002), more central-central screw positions (p = 0.014), and less poor screw placement (p = 0.001). The mortality rate was without effect between the three groups (log rank 0.698).
conclusionsDHS with or without TSP was associated with significantly higher rates of implant-related complications based on inferior radiographic measurements. Therefore, we only recommend PFNA for the treatment of proximal type AO/OTA 31-A2 femoral fractures. LEVEL OF EVIDENCE: Therapeutic level III.
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