{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:17:46Z","timestamp":1791451066185,"version":"4.3.3"},"reference-count":50,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"vor","delay-in-days":366,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedics &amp; Traumatology: Surgery &amp; Research"],"published-print":{"date-parts":[[2024,2]]},"DOI":"10.1016\/j.otsr.2023.103778","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T18:04:09Z","timestamp":1701281049000},"page":"103778","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":15,"special_numbering":"S","title":["Should trochanteric fractures in elderly patients be treated by arthroplasty or internal fixation?"],"prefix":"10.1016","volume":"110","author":[{"given":"Fran\u00e7ois","family":"Steffann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brice","family":"Rubens-Duval","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Huten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.otsr.2023.103778_bib0255","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1186\/s12891-018-2276-3","article-title":"Epidemiology, treatment and mortality of trochanteric and subtrochanteric hip fractures: data from the Swedish fracture register","volume":"19","author":"Mattisson","year":"2018","journal-title":"BMC Musculoskelet Disord"},{"key":"10.1016\/j.otsr.2023.103778_bib0260","doi-asserted-by":"crossref","first-page":"e17010","DOI":"10.1097\/MD.0000000000017010","article-title":"A meta-analysis comparing intramedullary with extramedullary fixations for unstable femoral intertrochanteric fractures","volume":"98","author":"Sun","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"10.1016\/j.otsr.2023.103778_bib0265","doi-asserted-by":"crossref","first-page":"700","DOI":"10.2106\/JBJS.G.00517","article-title":"Nail or plate fixation of intertrochanteric hip fractures: changing pattern of practice. A review of the American Board of Orthopaedic Surgery Database","volume":"90","author":"Anglen","year":"2008","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.otsr.2023.103778_bib0270","doi-asserted-by":"crossref","first-page":"S79","DOI":"10.1016\/j.otsr.2019.02.027","article-title":"Early mechanical complications following fixation of proximal femur fractures: from prevention to treatment","volume":"106","author":"Ehlinger","year":"2020","journal-title":"Orthop Traumatol Surg Res"},{"key":"10.1016\/j.otsr.2023.103778_bib0275","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1186\/1471-2474-11-133","article-title":"3066 consecutive Gamma nails. 12 years experience at a single centre","volume":"11","author":"Bojan","year":"2010","journal-title":"BMC Musculoskelet Dis"},{"key":"10.1016\/j.otsr.2023.103778_bib0280","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.otsr.2020.02.011","article-title":"Total hip arthroplasty with exclusive use of dual-mobility cup after failure of internal fixation in trochanteric fracture","volume":"106","author":"Favreau","year":"2020","journal-title":"Orthop Traumatol Surg Res"},{"key":"10.1016\/j.otsr.2023.103778_bib0285","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1302\/0301-620X.96B8.33644","article-title":"Predictors of failure for cepahalomedullary nailing of proximal femoral fractures","volume":"96B","author":"Kashigar","year":"2014","journal-title":"Bone Joint J"},{"key":"10.1016\/j.otsr.2023.103778_bib0290","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1007\/s00264-009-0826-x","article-title":"Total hip replacement as primary treatment of unstable intertrochanteric fractures in elderly patients","volume":"34","author":"Sidhu","year":"2010","journal-title":"Int Orthop"},{"key":"10.1016\/j.otsr.2023.103778_bib0295","first-page":"101","article-title":"Extracapsular proximal femoral fractures: indications for (primary) arthroplasty","volume":"15","author":"Saragaglia","year":"2015","journal-title":"Eur Instr Lect"},{"key":"10.1016\/j.otsr.2023.103778_bib0300","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s00264-006-0128-5","article-title":"Intramedullary fixation of intertrochanteric hip fractures: a comparison of two implant designs","volume":"31","author":"Efstathopoulos","year":"2007","journal-title":"Int Orthop"},{"key":"10.1016\/j.otsr.2023.103778_bib0305","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1007\/s00264-018-4014-8","article-title":"Osteoarthritis is associated with increased failure of proximal femoral fracture fixation","volume":"43","author":"Gallagher","year":"2019","journal-title":"Int Orthop"},{"key":"10.1016\/j.otsr.2023.103778_bib0310","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/j.otsr.2016.05.015","article-title":"Is arthroplasty preferable to internal fixation for the treatment of extracapsular fracture of the upper femur in the elderly?","volume":"102","author":"Duriez","year":"2016","journal-title":"Orthop Traumatol Surg Res"},{"key":"10.1016\/j.otsr.2023.103778_bib0315","doi-asserted-by":"crossref","first-page":"S95","DOI":"10.1016\/j.otsr.2011.06.009","article-title":"Trochanteric locking nail versus arthroplasty in unstable intertrochanteric fracture in patients aged over 75\u00a0years","volume":"97","author":"Bonnevialle","year":"2011","journal-title":"Orthop Traumatol Surg Res"},{"key":"10.1016\/j.otsr.2023.103778_bib0320","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1097\/00005131-199509040-00004","article-title":"Treatment of unstable peritrochanteric fractures in elderly patients with a compression hip screw or with the Vandeputte (VDP) endoprosthesis: a prospective randomised study","volume":"9","author":"Stappaerts","year":"1995","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.otsr.2023.103778_bib0325","first-page":"2186","article-title":"Cementless calcar-replacement hemiarthroplasty compared with intramedullary fixation of unstable intertrochanteric fractures. A prospective, randomized study","volume":"87","author":"Kim","year":"2005","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.otsr.2023.103778_bib0330","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1016\/j.injury.2015.05.024","article-title":"Intertrochanteric femur fractures in the elderly treated with either proximal femur nailing or hemiarthroplasty: a prospective randomised clinical study","volume":"46","author":"Ozkayin","year":"2015","journal-title":"Injury"},{"key":"10.1016\/j.otsr.2023.103778_bib0335","doi-asserted-by":"crossref","first-page":"E63","DOI":"10.25011\/cim.v38i1.22577","article-title":"Quality of life following treatment of trochanteric fractures with proximal femoral nail versus cementless bipolar hemiarthroplasty in elderly","volume":"38","author":"Desteli","year":"2015","journal-title":"Clin Invest Med"},{"key":"10.1016\/j.otsr.2023.103778_bib0340","first-page":"RC14","article-title":"A comparative study of the dynamic hip screw, the cemented bipolar hemiarthroplasty and the proximal femoral nail for the treatment of unstable intertrochanteric fractures","volume":"11","author":"Mansukhani","year":"2017","journal-title":"J Clin Diagn Res"},{"key":"10.1016\/j.otsr.2023.103778_bib0345","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18203\/issn.2455-4510.IntJResOrthop20172585","article-title":"Management of complex intertrochanteric fractures of the femur in elderly patients\u00a0\u2013\u00a0dynamic hip screws or proximal femoral nails or arthroplasty","volume":"3","author":"Hussain","year":"2017","journal-title":"Int J Res Orthop"},{"key":"10.1016\/j.otsr.2023.103778_bib0350","first-page":"7146","article-title":"Proximal femoral nail anti-rotation versus hip arthroplasty for osteoporotic intertrochanteric fracture: surgical effects and indications","volume":"11","author":"Zhang","year":"2018","journal-title":"Int J Clin Exp Med"},{"key":"10.1016\/j.otsr.2023.103778_bib0355","first-page":"296","article-title":"Comparison of complications and functional results of unstable intertrochanteric fractures of femur treated with proximal femur nails and cemented hemiarthroplasty","volume":"10","author":"Jolly","year":"2019","journal-title":"JCOT"},{"key":"10.1016\/j.otsr.2023.103778_bib0360","first-page":"CD00086","article-title":"Replacement arthroplasty versus internal fixation for extracapsular hip fractures in adults","volume":"2006","author":"Parker","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.otsr.2023.103778_bib0365","doi-asserted-by":"crossref","first-page":"102838","DOI":"10.1016\/j.otsr.2021.102838","article-title":"Fracture fixation versus hemiarthroplasty for unstable intertrochanteric fractures in elderly patients: a systematic review and network meta-analysis of randomized controlled trials","volume":"108","author":"Hongku","year":"2022","journal-title":"Orthop Traumatol Surg Res"},{"key":"10.1016\/j.otsr.2023.103778_bib0370","doi-asserted-by":"crossref","DOI":"10.1177\/21514593221118212","article-title":"Intramedullary nail or primary arthroplasty? A system review and meta-analysis on the prognosis of intertrochanteric femoral fractures based on randomized controlled trials","volume":"13","author":"Wang","year":"2022","journal-title":"Geriatr Orthop Surg Rehabil"},{"key":"10.1016\/j.otsr.2023.103778_bib0375","first-page":"CD013405","article-title":"Surgical interventions for treating extracapsular hip fractures in older adults: a network meta-analysis","volume":"2","author":"Lewis","year":"2022","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.otsr.2023.103778_bib0380","doi-asserted-by":"crossref","first-page":"858","DOI":"10.3346\/jkms.2017.32.5.858","article-title":"Early rehabilitation in elderly after arthroplasty versus internal fixation for unstable intertrochanteric fractures of femur: systematic review and meta-analysis","volume":"32","author":"Yoo","year":"2017","journal-title":"Korean Med Sci"},{"key":"10.1016\/j.otsr.2023.103778_bib0385","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1111\/os.12736","article-title":"Internal fixation versus hemiarthroplasty in the treatment of unstable intertrochanteric fractures in the elderly: a systematic review and meta-analysis","volume":"12","author":"Tu","year":"2020","journal-title":"Orthop Surg"},{"key":"10.1016\/j.otsr.2023.103778_bib0390","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s43465-021-00426-1","article-title":"Proximal femoral plate, intramedullary nail fixation versus hip arthroplasty for unstable intertrochanteric femoral fracture in the elderly: a meta-analysis","volume":"56","author":"El Madboh","year":"2021","journal-title":"Indian J Orthop"},{"key":"10.1016\/j.otsr.2023.103778_bib0395","doi-asserted-by":"crossref","first-page":"e7446","DOI":"10.1097\/MD.0000000000007446","article-title":"Comparison of intramedullary fixation and arthroplasty for the treatment of intertrochanteric hip fractures in the elderly. A meta-analysis","volume":"96","author":"Nie","year":"2017","journal-title":"Medicine (Baltimore)"},{"key":"10.1016\/j.otsr.2023.103778_bib0400","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1111\/os.12532","article-title":"Hip replacement as alternative to intramedullary nail in elderly patients with unstable intertrochanteric fracture: a systematic review and meta-analysis","volume":"11","author":"Ju","year":"2019","journal-title":"Orthop Surg"},{"key":"10.1016\/j.otsr.2023.103778_bib0405","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1007\/s00264-019-04351-9","article-title":"Proximal femoral nailing is superior to hemiarthroplasty in AO\/OTA A2 and A3 intertrochanteric femur fractures in the elderly: a systematic literature review and meta-analysis","volume":"44","author":"Kumar","year":"2020","journal-title":"Int Orthop"},{"key":"10.1016\/j.otsr.2023.103778_bib0410","doi-asserted-by":"crossref","first-page":"e24166","DOI":"10.1097\/MD.0000000000024166","article-title":"Comparison of clinical outcomes with hip replacement versus PFNA in the treatment of intertrochanteric fractures in the elderly: a systematic review and meta-analysis (PRISMA)","volume":"100","author":"Chen","year":"2021","journal-title":"Medicine (Baltimore)"},{"key":"10.1016\/j.otsr.2023.103778_bib0415","first-page":"209","article-title":"A multicenter intertrochanteric fracture study in the elderly: hemiarthroplasty versus proximal femoral nailing","volume":"31","author":"Ekinci","year":"2020","journal-title":"Jt Dis Relat Surg"},{"key":"10.1016\/j.otsr.2023.103778_bib0420","first-page":"S34","article-title":"Fracture and dislocation classification compendium-2018","volume":"32","author":"Orthopaedic Trauma Association","year":"2018","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.otsr.2023.103778_bib0425","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1097\/00005131-199310000-00006","article-title":"Healing complications after internal fixation of trochanteric hip fractures: the prognostic value of osteoporosis","volume":"7","author":"Barrios","year":"1993","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.otsr.2023.103778_bib0430","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1016\/j.arth.2017.10.027","article-title":"Mid-term survivals after cementless bipolar hemiarthroplasty for unstable intertrochanteric fractures in elderly patients","volume":"33","author":"Kim","year":"2018","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.otsr.2023.103778_bib0435","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1016\/j.otsr.2018.06.021","article-title":"Risk factors for cut-out after internal fixation of trochanteric fractures in elderly subjects","volume":"104","author":"Morvan","year":"2018","journal-title":"Orthop Trauma Surg and Res"},{"key":"10.1016\/j.otsr.2023.103778_bib0440","first-page":"29","article-title":"Le clou Gamma dans le traitement des fractures trochant\u00e9riennes. R\u00e9sultats \u00e0 propos de 121\u00a0cas","volume":"79","author":"Kempf","year":"1993","journal-title":"Rev Chir Orthop"},{"key":"10.1016\/j.otsr.2023.103778_bib0445","doi-asserted-by":"crossref","first-page":"103009","DOI":"10.1016\/j.otsr.2021.103009","article-title":"Significance of tip apex distance in intertrochanteric Fracture femur managed with Proximal femoral nailing","volume":"107","author":"Khannaa","year":"2021","journal-title":"Orthop Traumatol Surg Res"},{"key":"10.1016\/j.otsr.2023.103778_bib0450","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s00264-015-2794-7","article-title":"Arthroplasty for unstable pertrochanteric hip fractures may offer a lower re-operation rate as compared to cephalomedullary nailing","volume":"40","author":"Fichman","year":"2016","journal-title":"Intern Orthop"},{"key":"10.1016\/j.otsr.2023.103778_bib0455","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1007\/s00402-007-0423-7","article-title":"Trochanteric fractures in the elderly: the influence of primary hip arthroplasty on 1-year mortality","volume":"127","author":"Geiger","year":"2007","journal-title":"Arch Orthop Trauma Surg"},{"key":"10.1016\/j.otsr.2023.103778_bib0460","doi-asserted-by":"crossref","first-page":"S113","DOI":"10.1016\/j.otsr.2015.05.012","article-title":"Patient-specific risk factors for infection in arthroplasty procedure","volume":"102","author":"Marmor","year":"2016","journal-title":"Orthop Traumatol Surg Res"},{"key":"10.1016\/j.otsr.2023.103778_bib0465","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/j.1757-7861.2012.00173.x","article-title":"Unstable trochanteric fractures in elderly osteoporotic patients: role of primary hemiarthroplasty","volume":"4","author":"Karthik","year":"2012","journal-title":"Orthop Surg"},{"key":"10.1016\/j.otsr.2023.103778_bib0470","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1051\/sicotj\/2015015","article-title":"Transtrochanteric approach with coronal osteotomy of the great trochanter. A new technique for extra-capsular trochanteric fracture patients treated by total hip arthroplasty (THA) in elderly","volume":"1","author":"Steffann","year":"2015","journal-title":"SICOT J"},{"key":"10.1016\/j.otsr.2023.103778_bib0475","doi-asserted-by":"crossref","first-page":"79","DOI":"10.5371\/hp.2022.34.2.79","article-title":"Hemiarthroplasty through direct anterior approach for unstable femoral intertrochanteric fractures in the elderly: analysis of early cases","volume":"34","author":"Park","year":"2022","journal-title":"Hip Pelvis"},{"key":"10.1016\/j.otsr.2023.103778_bib0480","doi-asserted-by":"crossref","first-page":"103029","DOI":"10.1016\/j.otsr.2021.103029","article-title":"Dual mobility cups associated with proximal femoral replacement in non tumoral indications: results and complications","volume":"108","author":"Canetti","year":"2022","journal-title":"Orthop Traumatol Surg Res"},{"key":"10.1016\/j.otsr.2023.103778_bib0485","doi-asserted-by":"crossref","first-page":"e26395","DOI":"10.1097\/MD.0000000000026395","article-title":"Fixation options for reconstruction of the greater trochanter in unstable intertrochanteric fracture with arthroplasty","volume":"100","author":"Huang","year":"2021","journal-title":"Medicine (Baltimore)"},{"key":"10.1016\/j.otsr.2023.103778_bib0490","doi-asserted-by":"crossref","first-page":"103006","DOI":"10.1016\/j.otsr.2021.103006","article-title":"The influence of proximal femur canal size on reduction of intertrochanteric fracture with cephalomedullary nail","volume":"107","author":"Hsuan-Hsiao","year":"2021","journal-title":"Orthop Traumatol Surg Res"},{"key":"10.1016\/j.otsr.2023.103778_bib0495","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/j.arth.2005.04.035","article-title":"Perioperative morbidity and 30-day mortality after intertrochanteric hip fractures treated by internal fixation or arthroplasty","volume":"20","author":"Dobbs","year":"2005","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.otsr.2023.103778_bib0500","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.otsr.2019.06.022","article-title":"Factors associated with mortality due to trochanteric fracture. A cross-sectional study","volume":"106","author":"Velez","year":"2020","journal-title":"Orthop Traumatol Surg Res"}],"container-title":["Orthopaedics &amp; Traumatology: Surgery &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1877056823003304?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1877056823003304?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T03:51:41Z","timestamp":1761796301000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1877056823003304"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":50,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["S1877056823003304"],"URL":"https:\/\/doi.org\/10.1016\/j.otsr.2023.103778","relation":{},"ISSN":["1877-0568"],"issn-type":[{"value":"1877-0568","type":"print"}],"subject":[],"published":{"date-parts":[[2024,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Should trochanteric fractures in elderly patients be treated by arthroplasty or internal fixation?","name":"articletitle","label":"Article Title"},{"value":"Orthopaedics & Traumatology: Surgery & Research","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.otsr.2023.103778","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 Elsevier Masson SAS.","name":"copyright","label":"Copyright"}],"article-number":"103778"}}