{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:55:09Z","timestamp":1777924509634,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T00:00:00Z","timestamp":1739318400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"proximal femoral nail anti-rotation; Inter-trochanteric fracture; elderly; postoperative internal fixation; Cause of failure","award":["-"],"award-info":[{"award-number":["-"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Technology and Health Care"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to compare the efficacy and safety of Proximal Femoral Nail Anti-Rotation (PFNA) versus Dynamic Hip Screw (DHS) in the treatment of intertrochanteric fractures (IF) in elderly patients. We specifically evaluate perioperative indicators, postoperative hip function, and the rate of internal fixation failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>300 elderly IF patients treated in our hospital from July 2018 to May 2022 were divided into the PFNA group (n\u2009=\u2009150), control group (n\u2009=\u2009150), PFNA group treated with PFNA, and control group treated with mobility hip screw (DHS). Perioperative bleeding, operation time, postoperative time and hospital time were observed in the two groups: fracture reduction, hip function at 1 and 6 months after surgery, and failure of internal fixation. Observe the postoperative internal fixation failure in the PFNA group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The intraoperative blood loss, operation time, first postoperative time and hospital time in the PFNA group were less than in the control group (P\u2009&lt;\u20090.05). One month after surgery, the Harris score of the PFNA group was less than that of the control group (P\u2009&lt;\u20090.05); the Harris score was not different at 6 months (P\u2009&gt;\u20090.05). The excellent rate of fracture reduction in the PFNA group was greater than that in the control group (P\u2009&lt;\u20090.05). The failure rate of internal fixation in the PFNA group was less than that in the control group (P\u2009&lt;\u20090.05). By univariate analysis, Sing Index classification, Evans classification, 25\u2005min and underlying disease were risk factors for postoperative internal fixation failure in PFNA patients (P\u2009&lt;\u20090.05). After multivariate Logistic regression analysis, Sing Index grade, Evans classification, and tip distance 25min were independent risk factors for postoperative internal fixation failure in PFNA patients (P\u2009&lt;\u20090.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The treatment of elderly IF patients with PFNA has the advantages of small trauma, good fracture reduction, firm internal fixation, low failure rate of internal fixation, and quick postoperative recovery. Sing index classification, Evans classification, and 25min tip distance mainly caused internal fixation failure in patients with PFNA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09287329241307391","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T04:43:11Z","timestamp":1739335391000},"page":"1917-1925","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Analysis of elderly patients with inter-trochanteric fracture and failure of postoperative internal fixation"],"prefix":"10.1177","volume":"33","author":[{"given":"Xuepeng","family":"Xu","sequence":"first","affiliation":[{"name":"Departments of Bone and Joint Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Hu","sequence":"additional","affiliation":[{"name":"Departments of Bone and Joint Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lincong","family":"Fei","sequence":"additional","affiliation":[{"name":"Departments of Bone and Joint Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi","family":"Shen","sequence":"additional","affiliation":[{"name":"Departments of Bone and Joint Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,2,12]]},"reference":[{"key":"e_1_3_2_2_2","first-page":"189","article-title":"Intertrochanteric femur fracture treatment in Asia: what we know and what the world can learn","volume":"51","author":"Chang SM","unstructured":"Chang SM, Hou ZY, Hu SJ, et\u00a0al. Intertrochanteric femur fracture treatment in Asia: what we know and what the world can learn. Orthop Clin 2020 Apr 1; 51: 189\u2013205.","journal-title":"Orthop Clin"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.aott.2018.02.009"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2019.12.004"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.4055\/cios21058"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.33314\/jnhrc.v19i04.3946"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-021-04096-4"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2021.11.015"},{"key":"e_1_3_2_9_2","article-title":"Dynamic hip screw fixation vs. proximal femur nail for unstable per-trochanteric fractures: a comparative analysis of outcomes and complications","volume":"33","author":"Memon K","unstructured":"Memon K, Siddiqui AM, Khan ZA. Dynamic hip screw fixation vs. proximal femur nail for unstable per-trochanteric fractures: a comparative analysis of outcomes and complications. J Ayub Med Coll Abbottabad-Pak 2021 Jan 1; 33.","journal-title":"J Ayub Med Coll Abbottabad-Pak"},{"key":"e_1_3_2_10_2","first-page":"394","article-title":"Comparison of efficacy, complications and TGF\u2013\u03b22 expression between DHS and PFNA in elderly patients with osteoporotic femoral inter-trochanteric fracture","volume":"16","author":"Xu R","unstructured":"Xu R, Ru J, Ji F, et\u00a0al. Comparison of efficacy, complications and TGF\u2013\u03b22 expression between DHS and PFNA in elderly patients with osteoporotic femoral inter-trochanteric fracture. Exp Ther Med. 2018 Jul 1; 16: 394\u2013399.","journal-title":"Exp Ther Med."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2021.05.025"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.55730\/1300-0144.5334"},{"key":"e_1_3_2_13_2","first-page":"1016","article-title":"Comparison of proximal femoral nail anti-rotation and total hip arthroplasty in the treatment of the femoral inter-trochanteric fracture","volume":"38","author":"Li X","unstructured":"Li X, Xu J. Comparison of proximal femoral nail anti-rotation and total hip arthroplasty in the treatment of the femoral inter-trochanteric fracture. Pak J Med Sci. 2022 Mar; 38: 1016.","journal-title":"Pak J Med Sci."},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-03641-z"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2023.103778"},{"key":"e_1_3_2_16_2","first-page":"15562","article-title":"Analysis of risk factors for 90-day mortality after surgery in elderly patients with intertrochanteric fractures and a history of cardiovascular disease","volume":"11","author":"Yang L","unstructured":"Yang L, Yang H, Chen Q, et\u00a0al. Analysis of risk factors for 90-day mortality after surgery in elderly patients with intertrochanteric fractures and a history of cardiovascular disease. Ann Palliat Med. 2022 Jan; 11: 15562\u201315162.","journal-title":"Ann Palliat Med."},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v9.i22.6343"},{"key":"e_1_3_2_18_2","first-page":"755","article-title":"Evaluation of the inter and intra-observer reliability of the AO classification of inter-trochanteric fractures and the device choice (DHS, PFNA, and DCS) of fixations","volume":"30","author":"Zarie M","unstructured":"Zarie M, Mohamoud MF, Farhoud AR, et\u00a0al. Evaluation of the inter and intra-observer reliability of the AO classification of inter-trochanteric fractures and the device choice (DHS, PFNA, and DCS) of fixations. Ethiop J Health Sci. 2020 Sep 1; 30: 755\u2013760.","journal-title":"Ethiop J Health Sci."},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-020-03439-x"},{"key":"e_1_3_2_20_2","first-page":"292","article-title":"Risk factor analysis for failure of PFNA in inter-trochanteric fractures in the elderly","volume":"28","author":"Yuzhuo Z","year":"2020","unstructured":"Yuzhuo Z, Yuxin Q, Tengyang M, et\u00a0al. Risk factor analysis for failure of PFNA in inter-trochanteric fractures in the elderly. Chin J Orthop Surg 2020; 28: 292\u2013296.","journal-title":"Chin J Orthop Surg"},{"key":"e_1_3_2_21_2","first-page":"712","article-title":"Meta-analysis of factors for failing internal fixation between femoral trochanteric fractures","volume":"30","author":"Yawei L","year":"2022","unstructured":"Yawei L, Xuemei S, Mingqiang S, et\u00a0al. Meta-analysis of factors for failing internal fixation between femoral trochanteric fractures. Chin J Orthop Surg 2022; 30: 712\u2013716.","journal-title":"Chin J Orthop Surg"},{"key":"e_1_3_2_22_2","first-page":"1270","article-title":"Failure analysis of proximal femoral nail antirotation in treatment of geriatric inter-trochanteric fractures","volume":"33","author":"Chen P","unstructured":"Chen P, Fu D. Failure analysis of proximal femoral nail antirotation in treatment of geriatric inter-trochanteric fractures. Zhongguo xiu fu Chong Jian wai ke za zhi\u2009=\u2009Zhongguo Xiufu Chongjian Waike Zazhi\u2009=\u2009Chin J Reparative Reconstructive Surg 2019 Oct 1; 33: 1270\u20131274.","journal-title":"Zhongguo xiu fu Chong Jian wai ke za zhi\u2009=\u2009Zhongguo Xiufu Chongjian Waike Zazhi\u2009=\u2009Chin J Reparative Reconstructive Surg"}],"container-title":["Technology and Health Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09287329241307391","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09287329241307391","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09287329241307391","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T21:25:44Z","timestamp":1777670744000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09287329241307391"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,12]]},"references-count":21,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1177\/09287329241307391"],"URL":"https:\/\/doi.org\/10.1177\/09287329241307391","relation":{},"ISSN":["0928-7329","1878-7401"],"issn-type":[{"value":"0928-7329","type":"print"},{"value":"1878-7401","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,12]]}}}