Evidence map›Paper›PMID 41530738›Full record

ArticleBMC musculoskeletal disorders2026

Fracture stability modifies the risk profile and outcomes of proximal femoral nailing versus hemiarthroplasty for elderly intertrochanteric fractures.

Yusheng Zhang, Caizhen Luo, Wei Chen, Wanfei Wu, Huanyu Shi, Dongchu Zhao, Yan Xiong, Yang Li

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Yusheng ZhangDepartment of Emergency Medicine, Medical Center of Trauma and War Injury, Daping Hospital, Army Medical University, State Key Laboratory of Trauma and Chemical Poisoning, Chongqing, 400042, China.
Caizhen LuoMedical Center of Trauma and War Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China.
Wei ChenMedical Center of Trauma and War Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China.
Wanfei WuMedical Center of Trauma and War Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China.
Huanyu ShiMedical Center of Trauma and War Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China.
Dongchu ZhaoDepartment of Emergency Medicine, Medical Center of Trauma and War Injury, Daping Hospital, Army Medical University, State Key Laboratory of Trauma and Chemical Poisoning, Chongqing, 400042, China.
Yan XiongDepartment of Orthopedics, Daping Hospital, Army Medical University, No. 10, Daping Changjiang Branch Road, Yuzhong District, Chongqing, 400042, China. xiongyandoctor@tmmu.edu.cn.
Yang LiDepartment of Emergency Medicine, Medical Center of Trauma and War Injury, Daping Hospital, Army Medical University, State Key Laboratory of Trauma and Chemical Poisoning, No. 10, Daping Changjiang Branch Road, Yuzhong District, Chongqing, 400042, China. dpliyang@tmmu.edu.cn.ORCID http://orcid.org/0000-0003-2327-0444

Funding

Chongqing Science and Health Joint Project 2024MSXM084
6 · The paper itself

Abstract

backgroundWith population aging, intertrochanteric fractures (ITFs) in elderly individuals are increasingly common, and the choice between proximal femoral nail antirotation (PFNA) and hemiarthroplasty (HA) remains under debate, particularly regarding the optimal balance between early mobilization and the risk of long-term implant failure or revision. This study aimed to investigate this trade-off through a retrospective cohort comparison of PFNA and HA in elderly ITF patients stratified by fracture stability.

methodsThis retrospective cohort study reviewed 372 elderly patients with ITF treated from 2016 to 2022. Patients were grouped by surgery (PFNA or HA) and stratified by fracture stability (AO/OTA classification). The primary outcome was the Harris hip score (HHS) at 12 months post-operatively; secondary outcomes included perioperative metrics and complications.

resultsOverall, PFNA group demonstrated higher 12-month HHS (87.9 ± 5.8 vs. 84.6 ± 6.3, p < 0.001) despite longer operative duration, hospital stays, and delayed weight-bearing (p < 0.05) than HA. Subgroup analysis revealed no difference in HHS at 12 months for stable ITF patients. In the unstable subgroup, HA enabled earlier weight-bearing (4.5 ± 3.3 vs. 8.5 ± 3.7 days, p < 0.001), but PFNA demonstrated significantly better 12-month HHS (88.3 ± 6.3 vs. 82.5 ± 6.3, p < 0.001), with less blood loss and lower costs.

conclusionsFor stable ITFs in elderly patients, the PFNA and HA yield comparable outcomes. For unstable ITFs, a clinical trade-off exists: HA provides faster early mobilization, whereas PFNA offers superior long-term hip function. Implant choice should be tailored to patient life expectancy and functional goals.

Indexed as

Bone NailsHemiarthroplastyHip FracturesAgedAged, 80 and overFemaleHumansMalePostoperative ComplicationsProximal Femoral FracturesRetrospective StudiesRisk FactorsTreatment OutcomeFracture stabilityHemiarthroplastyIntertrochanteric fractureProximal femoral nail antirotationTrade-off

Identifiers

PMID41530738
PMCPMC12888606

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.