{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T03:24:17Z","timestamp":1792985057143,"version":"4.5.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,6,15]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Prior reports of the DePuy Synthes Trochanteric Fixation Nail Advanced (TFNA) revealed a potential mode of fatigue failure at the proximal screw aperture following fixation of extracapsular hip fractures. We sought to compare the revision risk between the TFNA and its prior-generation forebear, the Trochanteric Fixation Nail (TFN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective cohort study was performed using data from a U.S. integrated health-care system\u2019s hip fracture registry. The study sample comprised patients who underwent cephalomedullary nail fixation for hip fracture with a TFN (n = 4,007) or TFNA (n = 3,972) from 2014 to 2019. We evaluated the charts and radiographs for patients who underwent any revision. Multivariable Cox regression was used to evaluate the risk of revision related to the index fracture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>At the 3-year follow-up, the cumulative probability of revision related to the index fracture was 1.8% for the TFN and 1.9% for the TFNA. After adjustment for covariates, no difference was observed in revision risk (hazard ratio [HR], 1.18 [95% confidence interval (CI), 0.80 to 1.75]; p = 0.40) for the TFNA compared with the TFN. The TFNA was associated with a higher risk of revision for nonunion than the TFN (HR, 1.86 [95% CI, 1.11 to 3.12]; p = 0.018). At the 3-year follow-up, implant breakage was 0.06% for the TFN and 0.2% for the TFNA; with regard to aperture failures related to the index fracture, there were 1 failure for the TFN group and 3 failures for the TFNA group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In a large cohort from a U.S. hip fracture registry, the TFNA had an overall revision rate that was similar to that of the earlier TFN, with implant breakage being a rare revision reason for both groups. Chart and radiographic review found that the TFNA was associated with a higher risk of revision for nonunion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.21.01029","type":"journal-article","created":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T14:20:25Z","timestamp":1648218025000},"page":"1090-1097","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":16,"title":["Risk of Revision After Hip Fracture Fixation Using DePuy Synthes Trochanteric Fixation Nail or Trochanteric Fixation Nail Advanced"],"prefix":"10.2106","volume":"104","author":[{"given":"L. Henry","family":"Goodnough","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2877-8562","authenticated-orcid":false,"given":"Richard N.","family":"Chang","sequence":"additional","affiliation":[{"name":"Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian H.","family":"Fasig","sequence":"additional","affiliation":[{"name":"Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2200-6564","authenticated-orcid":false,"given":"Heather A.","family":"Prentice","sequence":"additional","affiliation":[{"name":"Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth W.","family":"Paxton","sequence":"additional","affiliation":[{"name":"Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn R.","family":"Diekmann","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Baldwin Park, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6344-2071","authenticated-orcid":false,"given":"James M.","family":"Jackman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwest Permanente Medical Group, Clackamas, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9310-9969","authenticated-orcid":false,"given":"Kanu","family":"Okike","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hawaii Permanente Medical Group, Honolulu, Hawaii"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew S.","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Permanente Medical Group, South San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,3,25]]},"reference":[{"key":"bib1-20250430","first-page":"172352","article-title":"Breakage of a third generation gamma nail: a case report and review of the literature","volume":"2013","author":"Iwakura","year":"2013","journal-title":"Case Rep 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