ArticleArchives of orthopaedic and trauma surgery2025
Comparison of antirotation proximal femoral nail and talon locking nail systems in the treatment of intertrochanteric fractures: functional and cost-effectiveness outcomes.
Article in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 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
- Integrated assessment of preoperative nutritional, inflammatory, and metabolic biomarkers and early outcomes in geriatric hip fracture surgery: a retrospective matched study.BMC geriatrics · 2026Article
- Risk factors for postoperative deep vein thrombosis during hospitalization in patients with hip fractures: a prospective nested case-control study.Scientific reports · 2026Article
- Comparative study on femoral neck fractures treatment: partial threaded cannulated screw versus different combinations of partial threaded cannulated screw and fully threaded headless cannulated screw.Journal of orthopaedic surgery and research · 2025Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study aimed to compare the clinical outcomes and cost-effectiveness of two widely used intramedullary fixation systems-the Proximal Femoral Nail Antirotation (PFNA) and the Proximal Femoral Nail with Talon Locking System (PFN-TLS)-in the treatment of intertrochanteric femur fractures (ITFF).
methodsA retrospective cohort study was conducted on 118 patients aged 65-90 years who underwent surgical treatment for ITFF using either PFNA (n = 53) or PFN-TLS (n = 65). All patients were followed for a minimum of 24 months. Preoperative functional evaluation was unavailable; outcomes were assessed at 24 months postoperatively. Surgical parameters, complication and revision rates, functional outcomes (Harris Hip Score [HHS], Visual Analog Scale [VAS], and SF-36), and health-economic indicators (Quality-Adjusted Life Years [QALY], Incremental Cost-Effectiveness Ratio [ICER]) were evaluated. Binary logistic regression analysis was performed to determine independent predictors of favorable functional outcomes.
resultsThe PFN-TLS group demonstrated significantly shorter surgical duration, reduced incision length, and lower fluoroscopy exposure (p < 0.05). At the 24-month follow-up, HHS was significantly higher in the PFN-TLS group (82.7 ± 7.4) compared to the PFNA group (76.4 ± 8.1; p = 0.001). VAS and SF-36 scores were also higher, although not statistically significant. Revision rates showed a non-significant trend favoring PFN-TLS. QALY gains were slightly higher in the PFN-TLS group (0.530 vs. 0.449), with a lower cost per QALY ($1,637.93 vs. $1,863.22). PFN-TLS use was independently associated with favorable functional outcomes (OR: 2.62; 95% CI 1.23-5.58; p = 0.013).
conclusionBoth PFNA and PFN-TLS are effective options for the management of ITFF. However, PFN-TLS may offer additional clinical and economic benefits, including improved functional outcomes and greater cost-efficiency. Findings should be interpreted with caution due to the retrospective design. Prospective, randomized studies are needed to validate these results and guide implant selection in clinical practice.
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