Sameer M, Muthu S, Vadranapu S. Prophylactic fixation in elderly fractures: Preventive breakthrough or unnecessary intervention? World J Orthop 2025; 16(11): 109855 [DOI: 10.5312/wjo.v16.i11.109855]
Corresponding Author of This Article
Sathish Muthu, MD, PhD, Assistant Professor, Central Research Laboratory, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research, Karrapettai Post, Enathur, Kanchipuram 631552, Tamil Nadu, India. drsathishmuthu@gmail.com
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Geriatrics & Gerontology
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Opinion Review
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 18, 2025 (publication date) through Nov 20, 2025
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Publication Name
World Journal of Orthopedics
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2218-5836
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Sameer M, Muthu S, Vadranapu S. Prophylactic fixation in elderly fractures: Preventive breakthrough or unnecessary intervention? World J Orthop 2025; 16(11): 109855 [DOI: 10.5312/wjo.v16.i11.109855]
World J Orthop. Nov 18, 2025; 16(11): 109855 Published online Nov 18, 2025. doi: 10.5312/wjo.v16.i11.109855
Prophylactic fixation in elderly fractures: Preventive breakthrough or unnecessary intervention?
Mohamed Sameer, Sathish Muthu, Srujun Vadranapu
Mohamed Sameer, Department of Orthopaedics, Sri Ramachandra Institute of Higher Education and Research, Chennai 600116, Tamil Nādu, India
Sathish Muthu, Central Research Laboratory, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research, Kanchipuram 631552, Tamil Nadu, India
Sathish Muthu, Department of Orthopaedics, Orthopaedic Research Group, Coimbatore 641045, Tamil Nādu, India
Srujun Vadranapu, Department of Orthopaedics, Royal Care Super Speciality Hospital, Coimbatore 641062, Tamil Nadu, India
Co-first authors: Mohamed Sameer and Sathish Muthu.
Author contributions: Sameer M, Muthu S, and Vadranapu S contributed significantly to the development and execution of this study; Muthu S conceptualised the study framework, led the manuscript drafting, and coordinated the research design; Sameer M performed data analysis, conducted literature synthesis, and contributed to critical revisions of the manuscript; Vadranapu S provided expertise in surgical methodologies, refined the discussion on feasibility, and ensured alignment with current orthopaedic practices; all authors reviewed and approved the final manuscript, ensuring accuracy, coherence, and relevance to the field of preventive orthopaedic care.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sathish Muthu, MD, PhD, Assistant Professor, Central Research Laboratory, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research, Karrapettai Post, Enathur, Kanchipuram 631552, Tamil Nadu, India. drsathishmuthu@gmail.com
Received: May 26, 2025 Revised: June 14, 2025 Accepted: October 24, 2025 Published online: November 18, 2025 Processing time: 174 Days and 23.5 Hours
Abstract
Prophylactic fixation (ProFix) of the proximal femur in elderly patients with osteoporosis presents a forward-thinking approach to preventing debilitating fractures and their associated complications. By addressing fracture risk before an injury occurs, ProFix has the potential to enhance patient outcomes, promote long-term mobility, and reduce healthcare costs. Early intervention in individuals at high risk can significantly lower hospital admissions, shorten recovery periods, and preserve independence, mitigating challenges such as chronic pain and reduced life expectancy. Given the high prevalence of undiagnosed osteoporosis, prioritising early risk assessment and targeted prevention is essential. Advancements in minimally invasive surgical techniques and safer anaesthesia methods further support ProFix as a feasible and effective strategy to decrease fracture-related morbidity, improve overall patient well-being, and optimise the use of healthcare resources. This opinion review details the evidence supporting this concept, its efficacy, the challenges in its implementation, and a strategic plan for future implementation.
Core Tip: Prophylactic fixation (ProFix) represents a paradigm shift in orthopaedic care, proactively addressing fracture risk in elderly osteoporotic patients before injury occurs. By integrating predictive analytics, minimally invasive techniques, and ethical considerations, ProFix has the potential to enhance mobility, reduce hospitalisation rates, and optimise healthcare resources. This review explores the feasibility, efficacy, and strategic implementation of ProFix, balancing innovation with patient safety to redefine preventive orthopaedic interventions.
