Observational studyArchives of orthopaedic and trauma surgery2022
High risks of failure observed for A1 trochanteric femoral fractures treated with a DHS compared to the PFNA in a prospective observational cohort study.
Observational study in Archives of orthopaedic and trauma surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Extramedullary versus intramedullary fixation of stable trochanteric femoral fractures: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2023Pooled it
- Biomechanical efficacy of a medial buttress plate in the management of concomitant ipsilateral subcapital and intertrochanteric femoral fractures: a finite element analysis.BMC musculoskeletal disorders · 2026Article
- Comparison of Hemiarthroplasty, total hip arthroplasty, and internal fixation for hip fractures in patients over eighty years of age: factors affecting mortality: a nationwide cohort study of fifty three thousand, four hundred and ninety five patients from Türkiye.International orthopaedics · 2025Article
- Mobility and living status at discharge and after three-months for extramedullary versus intramedullary fixation of AO type 31-A1 trochanteric fractures; an analysis of Dutch hip fracture audit data.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- [Research progress on weak state of lateral wall in intertrochanteric fractures].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2024Review
- Finite element analysis of the effect of residual lateral wall volume on postoperative stability in intertrochanteric fractures.Journal of orthopaedic surgery and research · 2024Article
- Association between hip fracture fixation methods and bone mineral density T-value in middle-aged and elderly patients with hip fractures.American journal of translational research · 2024Article
- Comparison of proximal femoral nail antirotation internal fixation and artificial hip replacement for elderly patients with intertrochanteric fractures.American journal of translational research · 2024Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionBoth the DHS and the PFNA are common and well-studied treatment options for stable trochanteric fractures. The aim of the current study was to compare the implant failure rates of these two implants in 31A1 type trochanteric femoral fractures. MATERIALS AND
methodsA single-centre observational cohort study was conducted in the Hip Fracture Unit of a multicentre level 1 trauma teaching hospital between December 2016 and October 2018. Patients with an AO/OTA type 31A1 fracture were included. Pathological fractures, bilateral fractures, high-energy traumas and patients younger than 18 years of age were excluded. Surgery was performed using either a DHS or PFNA. Both were used routinely for stable trochanteric fractures, and allocation was decided by the surgeon performing the operation. The primary outcome of this study was the implant failure rate in the first postoperative year. Secondary outcomes included the reoperation rate, functional recovery, pain and morphine use.
resultsData were available from 126 patients treated with a DHS (n = 32, 25.4%) or PFNA (n = 95, 74.6%). Minor differences were observed in the patient characteristics including the prevalence of cognitive impairment (18.8% vs 40.2%; P = 0.028), prefracture independence in activities of daily living (87.1% vs 67.4%; P = 0.034) and prefracture mobility (independently without aides: 61.3% vs 40.4%; P = 0.033). Fractures treated with a DHS showed 25% implant failures, compared to 1.1% for fractures treated with a PFNA (P = 0.004). No differences were observed in any of the secondary outcomes.
conclusionsSignificantly more implant failures were observed for the DHS compared the PFNA within 1 year after surgery. Despite the fact that this did not result in differences in revision surgery, we conclude that the PFNA, considering the minimal number of implant-related fractures is a viable implant for A1 type trochanteric fractures.
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