ArticleFrontiers in surgery2026
Clinical outcomes of PFNA vs. long-stem hemiarthroplasty for unstable proximal femur fractures in older adults: a retrospective cohort study.
Article in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Abstract
Objective: The optimal surgical management of unstable extracapsular proximal femur fractures (AO/OTA types A2 and A3) in elderly patients with osteoporosis remains controversial. This study compared clinical outcomes of proximal femoral nail antirotation (PFNA) vs. primary uncemented bipolar hemiarthroplasty with long femoral stem in patients aged ≥75 years. The primary outcome was reoperation rate within 24 months; secondary outcomes included perioperative parameters, functional recovery, complications and mortality. Methods: A retrospective comparative study was conducted including 174 patients (mean age 82.2 ± 7.1 years, 61.5% female) treated between January 2018 and December 2023. Patients underwent either PFNA ( Results: Mean operative time was shorter in the PFNA group (59.6 vs. 74.2 min, Conclusions: In geriatric patients with unstable extracapsular femoral fractures, long-stem hemiarthroplasty was associated with faster early recovery, lower reoperation rates, and a lower observed 2-year mortality compared to PFNA, which may be considered as an alternative primary option in appropriately selected elderly patients. However, given the retrospective design and potential for residual confounding, this observed association should not be interpreted as a causal effect, which should be confirmed by future prospective randomized trials.
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