Does proximal femoral nail antirotation achieve better outcome than previous-generation proximal femoral nail?

Table 1 Demographic details and fracture characteristics in the proximal femoral nail and proximal femoral nail antirotation groups

	PFN group	PFNA group	P value
Number of patients	73	85	NA
Male:female	31:42	37:48	0.893
Age, yr	76.6 (65-90)	74.9 (65-92)	0.213
BMI, kg/m2	21.4 (18.5-31.6)	22.8 (20.4-28.3)	0.576
Femoral BMD, T-score	-2.83 (-1.3 to -5.3)	-3.14(-1.1 to -6.1)	0.518
Charlson Comorbidity Index[15]	13.4 (3-18)	11.9 (4-19)	0.536
Cause of injury			0.890
Slip down	56	65
Traffic accident	8	11
Fall down	9	9
AO/OTA classification			0.750
31-A1	14	19
31-A2	42	50
31-A3	17	16
Stay before operation, d	4.02 (1-13)	2.84 (1-17)	0.253

PFN: Proximal femoral nail; PFNA: Proximal femoral nail antirotation; NA: Not available; BMI: Body mass index; BMD: Bone mineral density.

Table 2 Clinical outcomes in the proximal femoral nail and proximal femoral nail antirotation groups

	PFN group	PFNA group	P value
Operation time, min	67.3	63.2	0.395
Salvati and Wilson score score[16]			0.328
Excellent (32 or more)	26	36
Good (24-31)	35	44
Fair (16-23)	8	4
Poor (15 or less)	4	1
Excellent + good	61 (83.6%)	80 (94.1%)	0.033
Mortality within one year	16 (21.9%)	20 (23.5%)	0.629

PFN: Proximal femoral nail; PFNA: Proximal femoral nail antirotation.

Table 3 Radiographic results in the proximal femoral nail and proximal femoral nail antirotation groups

	PFN group	PFNA group	P value
Reduction			0.830
Good, n (%)	34 (46.6%)	42 (49.4%),
Normal, n (%)	31 (42.5%)	36 (42.4%)
Poor	8	7
Cleveland Index			0.577
Zone 1	0	0
Zone 2	1	0
Zone 3	0	0
Zone 4	2	2
Zone 5	34	42
Zone 6	11	15
Zone 7	3	4
Zone 8	14	19
Zone 9	8	3
Zone 5 + 6 + 8 + 9, n (%)	67 (91.8%)	79 (92.9%)	0.218
TAD, mm	7.2 (2.1-12.3)	7.9 (3.6-14.9)	0.222
Union rate, % (n)	87.7 (64/73)	94.1 (80/85)	0.155
Union time, wk	14.9 (12-17)	13.7 (11-18)	0.156
Sliding distance, mm	6.1 (0-23.6)	3.2 (0-18.4)	0.036

PFN: Proximal femoral nail; PFNA: Proximal femoral nail antirotation; TAD: Tip-apex distance.

Table 4 Complications in both groups

	PFN group	PFNA group	P value
Screw cutout, n (%)	8 (11.0%)	2 (2.4%)	0.027
Nonunion, n (%)	9 (12.3%)	5 (5.9%)	0.155
Infection	2	1	0.473
ONFH	1	0	0.279
Implant breakage	1	0	0.279

PFN: Proximal femoral nail; PFNA: Proximal femoral nail antirotation; ONFH: Osteonecrosis of the femoral head.