{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T01:53:26Z","timestamp":1781315606626,"version":"3.54.1"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Geriatr Orthop Surg Rehabil"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to investigate the effect of omitting a distal locking screw in intramedullary nailing of stable intertrochanteric femur fractures on clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Ninety-six patients over 65 years old with stable pertrochanteric fractures (AO\/OTA 31-A1 and A2) treated with short\/intermediate proximal femoral nails (PFNA-II) were randomly assigned into two groups: Group 1 (distal locked) and Group 2 (distal unlocked). Comparative analyses were conducted on operative time, total fluoroscopy time, blood loss, incision length, complications, and functional outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean operative time was significantly shorter in Group 2 (35.73 \u00b1 7.62 minutes) compared to Group 1 (47.40 \u00b1 9.96 minutes) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Fluoroscopy time was also shorter in Group 2 (45.92 \u00b1 6.08 seconds) compared to Group 1 (54.02 \u00b1 5.94 seconds) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Incision length was reduced in Group 2 (9.21 \u00b1 1.41\u00a0centimeters) compared to Group 1 (12.96 \u00b1 1.68\u00a0centimeters) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Blood loss was lower in Group 2 (187.50 \u00b1 32.00\u00a0milliliters) than in Group 1 (208.65 \u00b1 49.12\u00a0milliliters) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). There were no significant differences between the groups in fracture union time, hospital stay, fracture union weeks, or postoperative blood transfusion rates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Proximal femoral nailing without distal locking offers shorter operative times, reduced fluoroscopy exposure, and lower blood loss and complications, making it a viable option for treating stable intertrochanteric fractures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21514593251327910","type":"journal-article","created":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T13:49:28Z","timestamp":1743256168000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Advantages of Distal Unlocked Proximal Femoral Nails in the Treatment of Stable Intertrochanteric Fractures in Geriatric Patients: A Single-Center Comparative Randomized Study"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2651-8003","authenticated-orcid":false,"given":"S\u00f6nmez","family":"Sa\u011flam","sequence":"first","affiliation":[{"name":"Duzce University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7351-6305","authenticated-orcid":false,"given":"Omer","family":"Ersen","sequence":"additional","affiliation":[{"name":"Health Sciences University Medical Faculty Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harun Yasin","family":"T\u00fcz\u00fcn","sequence":"additional","affiliation":[{"name":"Health Sciences University Medical Faculty Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cemil","family":"Y\u0131ld\u0131z","sequence":"additional","affiliation":[{"name":"Health Sciences University Medical Faculty Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-015-2771-1"},{"issue":"4","key":"e_1_3_5_3_2","doi-asserted-by":"crossref","first-page":"S98","DOI":"10.1016\/j.injury.2016.07.038","article-title":"Is distal locking with short intramedullary nails necessary in stable pertrochanteric fractures? A prospective, multicentre, randomised study","volume":"47","author":"Caiaffa V","year":"2016","unstructured":"Caiaffa V, Vicenti G, Mori C, et al. Is distal locking with short intramedullary nails necessary in stable pertrochanteric fractures? A prospective, multicentre, randomised study. Injury. 2016;47(Suppl 4):S98-S106.","journal-title":"Injury"},{"issue":"7","key":"e_1_3_5_4_2","first-page":"e859","article-title":"Effect of distal interlock fixation in stable intertrochanteric fractures","volume":"36","author":"Kane PM","year":"2013","unstructured":"Kane PM, Vopat B, Paller D, Koruprolu S, Born CT. Effect of distal interlock fixation in stable intertrochanteric fractures. Orthopedics. 2013;36(7):e859-864.","journal-title":"Orthopedics"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/147323000903700410"},{"issue":"1","key":"e_1_3_5_6_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12306-015-0391-y","article-title":"How evolution of the nailing system improves results and reduces orthopedic complications: more than 2000 cases of trochanteric fractures treated with the gamma nail system","volume":"100","author":"Pascarella R","year":"2016","unstructured":"Pascarella R, Fantasia R, Maresca A, et al. How evolution of the nailing system improves results and reduces orthopedic complications: more than 2000 cases of trochanteric fractures treated with the gamma nail system. Musculoskelet Surg. 2016;100(1):1-8.","journal-title":"Musculoskelet Surg"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20151222-11"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.00517"},{"key":"e_1_3_5_9_2","first-page":"Cd000093","article-title":"Gamma and other cephalocondylic intramedullary nails versus extramedullary implants for extracapsular hip fractures in adults","volume":"9","author":"Parker MJ","year":"2010","unstructured":"Parker MJ, Handoll HH. Gamma and other cephalocondylic intramedullary nails versus extramedullary implants for extracapsular hip fractures in adults. Cochrane Database Syst Rev. 2010;9:Cd000093.","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"e_1_3_5_10_2","first-page":"56","article-title":"Distal locked versus unlocked intramedullary nailing in intertrochanteric fracture; a systematic review and meta-analysis of randomized and non-randomized trials","volume":"8","author":"Chouhan D","year":"2020","unstructured":"Chouhan D, Meena S, Kamboj K, Meena MK, Narang A, Sinha S. Distal locked versus unlocked intramedullary nailing in intertrochanteric fracture; a systematic review and meta-analysis of randomized and non-randomized trials. Bull Emerg Trauma. 2020;8(2):56-61.","journal-title":"Bull Emerg Trauma"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200702000-00004"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.73B2.2005167"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(99)00074-1"},{"issue":"7","key":"e_1_3_5_14_2","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1007\/s00264-009-0874-2","article-title":"Is distal locking with imhn necessary in every pertrochanteric fracture?","volume":"34","author":"Sk\u00e1la-Rosenbaum J","year":"2010","unstructured":"Sk\u00e1la-Rosenbaum J, Barton\u00edcek J, Bartoska R. Is distal locking with imhn necessary in every pertrochanteric fracture? Int Orthop. 2010;34(7):1041-1047.","journal-title":"Int Orthop"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-004-0744-8"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-019-03311-7"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15428"},{"issue":"4","key":"e_1_3_5_18_2","first-page":"209","article-title":"Risk factors for in-hospital mortality following hip fracture","volume":"61","author":"Sanz-Reig J","year":"2017","unstructured":"Sanz-Reig J, Salvador Mar\u00edn J, P\u00e9rez Alba JM, Ferr\u00e1ndez Mart\u00ednez J, Orozco Beltr\u00e1n D, Mart\u00ednez L\u00f3pez JF. Risk factors for in-hospital mortality following hip fracture. Rev Espa\u00f1ola Cirug\u00eda Ortop\u00e9dica Traumatol. 2017;61(4):209-215.","journal-title":"Rev Espa\u00f1ola Cirug\u00eda Ortop\u00e9dica Traumatol"},{"issue":"1","key":"e_1_3_5_19_2","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s00776-014-0667-3","article-title":"The risk factors of perioperative hemoglobin and hematocrit drop after intramedullary nailing treatment for intertrochanteric fracture patients","volume":"20","author":"Wang J","year":"2015","unstructured":"Wang J, Wei J, Wang M. The risk factors of perioperative hemoglobin and hematocrit drop after intramedullary nailing treatment for intertrochanteric fracture patients. J Orthop Sci. 2015;20(1):163-167.","journal-title":"J Orthop Sci"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.74B3.1587875"},{"issue":"4","key":"e_1_3_5_21_2","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.jcot.2014.06.001","article-title":"Is distal locking of long nails for intertrochanteric fractures necessary? A clinical study","volume":"5","author":"Vopat BG","year":"2014","unstructured":"Vopat BG, Kane PM, Truntzer J, et al. Is distal locking of long nails for intertrochanteric fractures necessary? A clinical study. J Clin Orthop Trauma. 2014;5(4):233-239.","journal-title":"J Clin Orthop Trauma"},{"issue":"1","key":"e_1_3_5_22_2","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1302\/0301-620X.86B1.14455","article-title":"Treatment of unstable trochanteric fractures. Randomised comparison of the gamma nail and the proximal femoral nail","volume":"86","author":"Schipper IB","year":"2004","unstructured":"Schipper IB, Steyerberg EW, Castelein RM, et al. Treatment of unstable trochanteric fractures. Randomised comparison of the gamma nail and the proximal femoral nail. J Bone Joint Surg Br. 2004;86(1):86-94.","journal-title":"J Bone Joint Surg Br"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-018-0749-6"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-020-02031-8"},{"issue":"2","key":"e_1_3_5_25_2","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1302\/0301-620X.77B2.7706346","article-title":"Prevention of fracture at the distal locking site of the gamma nail. A biomechanical study","volume":"77","author":"Lacroix H","year":"1995","unstructured":"Lacroix H, Arwert H, Snijders CJ, Fontijne WP. Prevention of fracture at the distal locking site of the gamma nail. A biomechanical study. J Bone Joint Surg Br. 1995;77(2):274-276.","journal-title":"J Bone Joint Surg Br"},{"issue":"12","key":"e_1_3_5_26_2","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1097\/BOT.0000000000000165","article-title":"A biomechanical comparison of locked and unlocked long cephalomedullary nails in a stable intertrochanteric fracture model","volume":"28","author":"Kane P","year":"2014","unstructured":"Kane P, Vopat B, Paller D, Koruprolu S, Daniels AH, Born C. A biomechanical comparison of locked and unlocked long cephalomedullary nails in a stable intertrochanteric fracture model. J Orthop Trauma. 2014;28(12):715-720.","journal-title":"J Orthop Trauma"},{"issue":"4","key":"e_1_3_5_27_2","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1007\/s00590-018-2143-9","article-title":"Comparison between locked and unlocked intramedullary nails in intertrochanteric fractures","volume":"28","author":"Lanzetti RM","year":"2018","unstructured":"Lanzetti RM, Caraffa A, Lupariello D, et al. Comparison between locked and unlocked intramedullary nails in intertrochanteric fractures. Eur J Orthop Surg Traumatol. 2018;28(4):649-658.","journal-title":"Eur J Orthop Surg Traumatol"},{"issue":"2","key":"e_1_3_5_28_2","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.otsr.2014.12.011","article-title":"The Asia proximal femoral nail antirotation versus the standard proximal femoral antirotation nail for unstable intertrochanteric fractures in elderly Chinese patients","volume":"101","author":"Li J","year":"2015","unstructured":"Li J, Cheng L, Jing J. The Asia proximal femoral nail antirotation versus the standard proximal femoral antirotation nail for unstable intertrochanteric fractures in elderly Chinese patients. Orthop Traumatol Surg Res. 2015;101(2):143-146.","journal-title":"Orthop Traumatol Surg Res"},{"key":"e_1_3_5_29_2","doi-asserted-by":"crossref","first-page":"94277","DOI":"10.52965\/001c.94277","article-title":"The retrospective analysis of trigen intertan nail in the treatment of unstable intertrochanteric femoral fractures at hospital for traumatology and orthopaedics","volume":"16","author":"Nguyen TA","year":"2024","unstructured":"Nguyen TA, Hoang AQ, Phan TN, Nguyen TX, Nguyen NN, Nguy\u1ec5n PD. The retrospective analysis of trigen intertan nail in the treatment of unstable intertrochanteric femoral fractures at hospital for traumatology and orthopaedics. Orthop Rev. 2024;16:94277.","journal-title":"Orthop Rev"},{"issue":"1","key":"e_1_3_5_30_2","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1186\/s12891-024-07933-w","article-title":"Flexible reamer use to overcome entry point errors in proximal femoral nail application in severe obese intertrochanteric fracture patients","volume":"25","author":"Horoz L","year":"2024","unstructured":"Horoz L, Kilic AI, Kircil C, Cakmak MF. Flexible reamer use to overcome entry point errors in proximal femoral nail application in severe obese intertrochanteric fracture patients. BMC Muscoskelet Disord. 2024;25(1):810.","journal-title":"BMC Muscoskelet Disord"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aei010"},{"issue":"4","key":"e_1_3_5_32_2","doi-asserted-by":"crossref","first-page":"S10","DOI":"10.1097\/BOT.0000000000000286","article-title":"Nailing intertrochanteric hip fractures: short versus long; locked versus nonlocked","volume":"29","author":"Kanakaris NK","year":"2015","unstructured":"Kanakaris NK, Tosounidis TH, Giannoudis PV. Nailing intertrochanteric hip fractures: short versus long; locked versus nonlocked. J Orthop Trauma. 2015;29(Suppl 4):S10-16.","journal-title":"J Orthop Trauma"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200501000-00009"},{"issue":"5","key":"e_1_3_5_34_2","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1302\/0301-620X.75B5.8376441","article-title":"A prospective randomised comparison of the dynamic hip screw and the gamma locking nail","volume":"75","author":"Radford PJ","year":"1993","unstructured":"Radford PJ, Needoff M, Webb JK. A prospective randomised comparison of the dynamic hip screw and the gamma locking nail. J Bone Joint Surg Br. 1993;75(5):789-793.","journal-title":"J Bone Joint Surg Br"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2009.04.014"}],"container-title":["Geriatric Orthopaedic Surgery &amp; Rehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21514593251327910","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21514593251327910","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21514593251327910","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:09:35Z","timestamp":1777446575000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21514593251327910"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":34,"alternative-id":["10.1177\/21514593251327910"],"URL":"https:\/\/doi.org\/10.1177\/21514593251327910","relation":{},"ISSN":["2151-4593","2151-4593"],"issn-type":[{"value":"2151-4593","type":"print"},{"value":"2151-4593","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,28]]},"article-number":"21514593251327910"}}