Evidence map›Paper›PMID 41847566›Full record

ReviewFrontiers in surgery2026

Hemiarthroplasty vs. proximal femoral nail fixation in unstable pertrochanteric fractures: an updated systematic review and meta-analysis.

Ming-Ming Zhang, Shuang-Shuang Yuan, Hong-Hua Dong, Chao Wang

Abstract readReview
In one paragraph

Review in Frontiers in surgery, 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

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Ming-Ming ZhangDepartment of Orthopedics, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng Third People's Hospital, Yancheng, Jiangsu, China.
Shuang-Shuang YuanDepartment of Orthopedics, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng Third People's Hospital, Yancheng, Jiangsu, China.
Hong-Hua DongDepartment of Orthopedics, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng Third People's Hospital, Yancheng, Jiangsu, China.
Chao WangDepartment of Orthopedics, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng Third People's Hospital, Yancheng, Jiangsu, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Pertrochanteric fractures are common and challenging for surgeons, especially in unstable conditions. Proximal femoral nails or nails anti-rotation variants are well-established surgical instruments to treat this, but some reports suggest that in unstable situations, hemiarthroplasty provides superior benefits to patients. This study aimed to compare hemiarthroplasty with proximal femoral nails, highlighting the differences to assist surgical decision-making. Methods: Online databases were searched for eligible studies in accordance with PRISMA guidelines. Results were analyzed across 18 domains, categorized into three branches: function, complication, and perioperative condition and mortality. Effect sizes were calculated, and the heterogeneities thereof were analyzed. We also tested sensitivity, publication biases, and graded certainty of evidence. Finally, comprehensive results were interpreted. Results: Twenty-seven studies, with a total of 2,517 patients, were included. The hemiarthroplasty performed better than nails in early Harris hip scores, full weight-bearing time, and complication rate related to implants. Proximal femoral nails performed better in terms of surgery duration and superficial infection. No significant differences were observed in final Harris hip scores, general and implant-unrelated complications, mortality, hospital stay, re-operation incidence, bedsores, and deep venous thrombosis. Ambulation time, blood loss, and transfusion incidence showed potential publication bias. Conclusion: Hemiarthroplasty and proximal femoral nails/nails anti-rotation are effective methods for treating unstable pertrochanteric fractures. No clinically important differences-such as re-operation rates due to implant-related complications-were identified between these two tactics. Surgeons should prioritize internal fixations, barring conditions wherein hemiarthroplasty is essential.

Indexed as

hemiarthroplastyhip fracture (HFr)hip surgerypertrochanteric fracturesproximal femoral nail

Identifiers

PMID41847566
PMCPMC12989514

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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.