ArticleScientific reports2025
Distal locking mechanism influences surgical and radiological outcomes in proximal femoral nailing using distal wedge versus distal screw designs.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Internal-locking intramedullary nails (talons, claws, wings, wedge-locks, endopins): a mechanics-guided scoping review of designs, failure signatures, and technique imperatives.BMC musculoskeletal disorders · 2026Article
- Comparison of antirotation proximal femoral nail and talon locking nail systems in the treatment of intertrochanteric fractures: functional and cost-effectiveness outcomes.Archives of orthopaedic and trauma surgery · 2025Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This study aims to evaluate the radiological outcomes of two proximal femoral nails that share similar proximal geometry and sizes, but differ in their distal locking mechanisms. This retrospective study included 244 patients with AO 31-A1/A3 intertrochanteric fractures treated with either Wedge-wing proximal femoral nail (Ww-PFN) (n = 158) or Distally Wedge proximal femoral nail (Dw-PFN) (n = 86). Radiological parameters such as fracture reduction quality, tip-apex distance (TAD), neck-shaft angle (NSA) and time to fracture healing were compared. The Dw-PFN group demonstrated significantly shorter fracture healing time (12.45 ± 9.7 vs. 15.0 ± 3.4 months, p < 0.001) and better fracture reduction quality (p < 0.001) compared to the Ww-PFN group. NSA decreased in both groups postoperatively, with a greater mean decrease observed in the Dw-PFN group; this difference was not statistically significant (p = 0.175). However, complication rates were not different. (p = 0.342). The expandable talon mechanism of the Dw-PFN was associated with significantly faster fracture healing and shorter surgical duration compared to the Ww-PFN system. The mean surgical time was 34.1 ± 6.5 min for the Dw-PFN group and 50.6 ± 10.4 min for the Ww-PFN group (p = 0.001). These findings suggest that the talon-type distal fixation may be a favorable alternative in clinical practice. Notably, despite the lower rate of good fracture reduction in the Dw-PFN group (28.5% vs. 71.3%), complication and failure rates were comparable, further supporting the safety and clinical feasibility of this locking mechanism.
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