{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T08:55:40Z","timestamp":1790758540004,"version":"4.1.0"},"reference-count":24,"publisher":"EDP Sciences","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":272,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SICOT-J"],"accepted":{"date-parts":[[2026,3,31]]},"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    : Unstable trochanteric fractures pose a significant challenge in orthopedic surgery, particularly in elderly patients with poor bone quality. Achieving biomechanical stability while minimizing complications requires careful consideration of intramedullary nail design. This study aims to compare two commonly used implants \u2013 Proximal Femoral Nail Anti-rotation-2 (PFNA-2) and Halifax Femoral Nail \u2013 by evaluating their clinical, radiological, and functional outcomes, with a focus on surgical efficacy, complications, and functional recovery.\n                    <jats:italic>Methods<\/jats:italic>\n                    : A prospective, randomized clinical trial involving 60 elderly patients with AO\/OTA 31A2 or 31A3 unstable trochanteric fractures was conducted over 1 year. Patients aged 60\u201380\u00a0years were randomized into two equal groups (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a030 each) to receive either PFNA-2 or Halifax Nail fixation. Primary outcomes were evaluated using the Harris Hip Score (HHS) at 6 and 12\u00a0months postoperatively. Secondary outcome measures included neck-shaft angle, tip-apex distance, and screw positioning according to the Cleveland Index. Operative parameters, including surgical time, blood loss, and complications, were systematically recorded and analyzed.\n                    <jats:italic>Results<\/jats:italic>\n                    : Both implants demonstrated comparable efficacy regarding operative time (Halifax: 31.7\u00a0\u00b1\u00a05.5 vs. PFNA-2: 33.0\u00a0\u00b1\u00a07.9\u00a0min,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.45) and intraoperative blood loss (Halifax: 89.5\u00a0\u00b1\u00a012.6 vs.PFNA-2: 97.7\u00a0\u00b1\u00a022.9\u00a0ml,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.09). Halifax Nail achieved significantly superior screw positioning with 76.7% optimal center\u2013center placement compared to 43.3% in the PFNA-2 group (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.008). Subsidence was absent in the Halifax group but occurred in 6.7% of PFNA-2 cases. HHSs improved progressively in both groups, with Halifax showing marginally higher scores at 6\u00a0months (83.6\u00a0\u00b1\u00a04.3 vs.81.5\u00a0\u00b1\u00a06.4) and 12\u00a0months (87.4\u00a0\u00b1\u00a03.9 vs.85.8\u00a0\u00b1\u00a05.6), though differences were not statistically significant.\n                    <jats:italic>Discussion<\/jats:italic>\n                    : Both PFNA-2 and Halifax Nails are effective for managing unstable trochanteric fractures. The Halifax Nail\u2019s innovative tri-wire technology\u2122 offers superior rotational stability, optimal screw positioning, and demonstrates a trend towards reduced subsidence, making it particularly advantageous for patients with compromised bone quality. These findings support individualized implant selection based on patient factors and bone quality assessment.\n                  <\/jats:p>","DOI":"10.1051\/sicotj\/2026027","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:59:36Z","timestamp":1790755176000},"page":"58","source":"Crossref","is-referenced-by-count":0,"title":["The impact of subsidence on hip function: A comparative study between Proximal Femoral Nail Anti-rotation-2 and Halifax Femoral Nail in unstable trochanteric fractures"],"prefix":"10.1051","volume":"12","author":[{"given":"Soumya Ranjan","family":"Nayak","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Institute of Medical Sciences, Banaras Hindu University","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Rastogi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Institute of Medical Sciences, Banaras Hindu University","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivam","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Institute of Medical Sciences, Banaras Hindu University","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birju","family":"Manjhi","sequence":"additional","affiliation":[{"name":"Trauma Centre, Banaras Hindu University","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Rai","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Institute of Medical Sciences, Banaras Hindu University","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushil","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Institute of Medical Sciences, Banaras Hindu University","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"250","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"R1","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1016\/j.bone.2007.08.026","volume":"41","author":"Haentjens","year":"2007","journal-title":"Bone"},{"key":"R2","doi-asserted-by":"crossref","first-page":"179","DOI":"10.5435\/00124635-200405000-00006","volume":"12","author":"Lindskog","year":"2004","journal-title":"J Am Acad Orthop Surg"},{"key":"R3","doi-asserted-by":"crossref","first-page":"M635","DOI":"10.1093\/gerona\/54.12.M635","volume":"54","author":"Fox","year":"1999","journal-title":"J Gerontol Ser A Biol Sci Med Sci"},{"key":"R4","first-page":"124","volume":"74","author":"Hammer","year":"1988","journal-title":"S Afr Med J"},{"key":"R5","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1016\/j.injury.2020.10.067","volume":"52","author":"Chan","year":"2021","journal-title":"Injury"},{"key":"R6","first-page":"2616","volume":"15","author":"Tunio","year":"2021","journal-title":"PJMHS"},{"key":"R7","first-page":"1","volume":"2020","author":"Fu","year":"2020","journal-title":"BioMed Res Int"},{"key":"R8","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/00003086-199309000-00025","volume":"1993","author":"Barrios","year":"1993","journal-title":"Clin Orthop Relat Res"},{"key":"R9","doi-asserted-by":"crossref","unstructured":"Siddiqui YS, Khan AQ, Asif N, et al. 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