{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T14:58:49Z","timestamp":1793199529633,"version":"4.5.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate the horizontal positioning (HP) technique for the precise lateral insertion of the helical blade guide pin during proximal femoral nail antirotation (PFNA) procedures for elderly osteoporotic patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study involved elderly osteoporotic patients with femoral intertrochanteric fractures treated at Tianjin Union Medical Center from January to December 2024. Patients were categorized into the HP group and the traditional true lateral view (TLV) group. The analyzed variables included fracture classification, horizontal anteversion angle (HAA), success rate of one-time lateral pin placement (SR-OLPP), pin insertion time, frequency of intraoperative lateral fluoroscopy images (FILFI), Parker's ratio index, lag screw placement, tip-apex distance (TAD), and reduction quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 86 patients participated in the study (HP group:\n                      <jats:italic>n<\/jats:italic>\n                      = 46; TLV group:\n                      <jats:italic>n<\/jats:italic>\n                      = 40), with no significant differences in baseline characteristics between the groups. The HP group demonstrated a significantly shorter pin insertion time compared to the TLV group [1 (\n                      <jats:xref>1<\/jats:xref>\n                      \u2013\n                      <jats:xref>3<\/jats:xref>\n                      ) vs. 3 (\n                      <jats:xref>2<\/jats:xref>\n                      \u2013\n                      <jats:xref>5<\/jats:xref>\n                      ) min,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001] and required fewer intraoperative lateral fluoroscopy images [1 (\n                      <jats:xref>1<\/jats:xref>\n                      \u2013\n                      <jats:xref>3<\/jats:xref>\n                      ) vs. 3 (\n                      <jats:xref>2<\/jats:xref>\n                      \u2013\n                      <jats:xref>6<\/jats:xref>\n                      ),\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001]. The horizontal anteversion angle in the HP group was 6.4 \u00b1 6.3\u00b0. The success rate of one-time lateral pin placement was higher in the HP group (95.7 vs. 85.0%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.138). No significant differences were found between two groups concerning reduction quality or spiral blade position and short-term post-operative complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HP technology may enhance surgical efficiency and reduce radiation exposure while maintaining surgical safety and the accuracy of nail placement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1702771","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T06:34:38Z","timestamp":1771310078000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Horizontal positioning for accurate lateral helical blade insertion in proximal femoral nail antirotation (PFNA) for elderly osteoporotic patients"],"prefix":"10.3389","volume":"13","author":[{"given":"Yanqing","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sen","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongliang","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"605","DOI":"10.3390\/medicina61040605","article-title":"A novel interfragmentary technique vs. a conventional posterolateral approach for unstable femoral intertrochanteric fractures in the elderly: a retrospective cohort study","volume":"61","author":"Zora","year":"2025","journal-title":"Medicina (Kaunas)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"121","DOI":"10.2217\/cer-2021-0258","article-title":"Early mobilization in enhanced recovery after surgery pathways: current evidence and recent advancements","volume":"11","author":"Tazreean","year":"2022","journal-title":"J Comp Eff Res."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e0304654","DOI":"10.1371\/journal.pone.0304654","article-title":"Proximal femoral nail antirotation versus InterTan nail for the treatment of intertrochanteric fractures: a systematic review and meta-analysis","volume":"19","author":"Liao","year":"2024","journal-title":"PLoS ONE."},{"key":"B4","doi-asserted-by":"publisher","first-page":"3836","DOI":"10.1038\/s41598-025-88229-4","article-title":"Robot-assisted PFNA surgery improves clinical outcomes in the treatment of unstable femoral intertrochanteric fractures in elderly patients compared with traditional PFNA surgery","volume":"15","author":"Lu","year":"2025","journal-title":"Sci Rep."},{"key":"B5","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s12995-020-00276-x","article-title":"et al. 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