Distal locking mechanism influences surgical and radiological outcomes in proximal femoral nailing using distal wedge versus distal screw designs
Abstract This study aims to evaluate the radiological outcomes of two proximal femoral nails that share similar proximal geometry and sizes, but differ in their distal locking mechanisms. This retrospective study included 244 patients with AO 31-A1/A3 intertrochanteric fractures treated with either...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-07-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-025-08079-y |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849766236125134848 |
|---|---|
| author | Aytek Hüseyin Çeliksöz Büşra Tokmak Ali Okan Tarlacık Servet Igrek |
| author_facet | Aytek Hüseyin Çeliksöz Büşra Tokmak Ali Okan Tarlacık Servet Igrek |
| author_sort | Aytek Hüseyin Çeliksöz |
| collection | DOAJ |
| description | Abstract This study aims to evaluate the radiological outcomes of two proximal femoral nails that share similar proximal geometry and sizes, but differ in their distal locking mechanisms. This retrospective study included 244 patients with AO 31-A1/A3 intertrochanteric fractures treated with either Wedge-wing proximal femoral nail (Ww-PFN) (n = 158) or Distally Wedge proximal femoral nail (Dw-PFN) (n = 86). Radiological parameters such as fracture reduction quality, tip-apex distance (TAD), neck-shaft angle (NSA) and time to fracture healing were compared. The Dw-PFN group demonstrated significantly shorter fracture healing time (12.45 ± 9.7 vs. 15.0 ± 3.4 months, p < 0.001) and better fracture reduction quality (p < 0.001) compared to the Ww-PFN group. NSA decreased in both groups postoperatively, with a greater mean decrease observed in the Dw-PFN group; this difference was not statistically significant (p = 0.175). However, complication rates were not different. (p = 0.342). The expandable talon mechanism of the Dw-PFN was associated with significantly faster fracture healing and shorter surgical duration compared to the Ww-PFN system. The mean surgical time was 34.1 ± 6.5 min for the Dw-PFN group and 50.6 ± 10.4 min for the Ww-PFN group (p = 0.001). These findings suggest that the talon-type distal fixation may be a favorable alternative in clinical practice. Notably, despite the lower rate of good fracture reduction in the Dw-PFN group (28.5% vs. 71.3%), complication and failure rates were comparable, further supporting the safety and clinical feasibility of this locking mechanism. |
| format | Article |
| id | doaj-art-3dbed2796abb472cacc95638ec141eb5 |
| institution | DOAJ |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-3dbed2796abb472cacc95638ec141eb52025-08-20T03:04:38ZengNature PortfolioScientific Reports2045-23222025-07-011511810.1038/s41598-025-08079-yDistal locking mechanism influences surgical and radiological outcomes in proximal femoral nailing using distal wedge versus distal screw designsAytek Hüseyin Çeliksöz0Büşra Tokmak1Ali Okan Tarlacık2Servet Igrek3Orthopedics and Traumatology, Eskişehir City HospitalOrthopedics and Traumatology, Igdir State HospitalOrthopedics and Traumatology, Eskişehir City HospitalOrthopedics and Traumatology, Kartal Education and Research HospitalAbstract This study aims to evaluate the radiological outcomes of two proximal femoral nails that share similar proximal geometry and sizes, but differ in their distal locking mechanisms. This retrospective study included 244 patients with AO 31-A1/A3 intertrochanteric fractures treated with either Wedge-wing proximal femoral nail (Ww-PFN) (n = 158) or Distally Wedge proximal femoral nail (Dw-PFN) (n = 86). Radiological parameters such as fracture reduction quality, tip-apex distance (TAD), neck-shaft angle (NSA) and time to fracture healing were compared. The Dw-PFN group demonstrated significantly shorter fracture healing time (12.45 ± 9.7 vs. 15.0 ± 3.4 months, p < 0.001) and better fracture reduction quality (p < 0.001) compared to the Ww-PFN group. NSA decreased in both groups postoperatively, with a greater mean decrease observed in the Dw-PFN group; this difference was not statistically significant (p = 0.175). However, complication rates were not different. (p = 0.342). The expandable talon mechanism of the Dw-PFN was associated with significantly faster fracture healing and shorter surgical duration compared to the Ww-PFN system. The mean surgical time was 34.1 ± 6.5 min for the Dw-PFN group and 50.6 ± 10.4 min for the Ww-PFN group (p = 0.001). These findings suggest that the talon-type distal fixation may be a favorable alternative in clinical practice. Notably, despite the lower rate of good fracture reduction in the Dw-PFN group (28.5% vs. 71.3%), complication and failure rates were comparable, further supporting the safety and clinical feasibility of this locking mechanism.https://doi.org/10.1038/s41598-025-08079-yProximal femoral nailIntertrochanteric fractureDistal lockingWedge lockingFracture union |
| spellingShingle | Aytek Hüseyin Çeliksöz Büşra Tokmak Ali Okan Tarlacık Servet Igrek Distal locking mechanism influences surgical and radiological outcomes in proximal femoral nailing using distal wedge versus distal screw designs Scientific Reports Proximal femoral nail Intertrochanteric fracture Distal locking Wedge locking Fracture union |
| title | Distal locking mechanism influences surgical and radiological outcomes in proximal femoral nailing using distal wedge versus distal screw designs |
| title_full | Distal locking mechanism influences surgical and radiological outcomes in proximal femoral nailing using distal wedge versus distal screw designs |
| title_fullStr | Distal locking mechanism influences surgical and radiological outcomes in proximal femoral nailing using distal wedge versus distal screw designs |
| title_full_unstemmed | Distal locking mechanism influences surgical and radiological outcomes in proximal femoral nailing using distal wedge versus distal screw designs |
| title_short | Distal locking mechanism influences surgical and radiological outcomes in proximal femoral nailing using distal wedge versus distal screw designs |
| title_sort | distal locking mechanism influences surgical and radiological outcomes in proximal femoral nailing using distal wedge versus distal screw designs |
| topic | Proximal femoral nail Intertrochanteric fracture Distal locking Wedge locking Fracture union |
| url | https://doi.org/10.1038/s41598-025-08079-y |
| work_keys_str_mv | AT aytekhuseyinceliksoz distallockingmechanisminfluencessurgicalandradiologicaloutcomesinproximalfemoralnailingusingdistalwedgeversusdistalscrewdesigns AT busratokmak distallockingmechanisminfluencessurgicalandradiologicaloutcomesinproximalfemoralnailingusingdistalwedgeversusdistalscrewdesigns AT aliokantarlacık distallockingmechanisminfluencessurgicalandradiologicaloutcomesinproximalfemoralnailingusingdistalwedgeversusdistalscrewdesigns AT servetigrek distallockingmechanisminfluencessurgicalandradiologicaloutcomesinproximalfemoralnailingusingdistalwedgeversusdistalscrewdesigns |