{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:55:16Z","timestamp":1787028916111,"version":"build-2736575974"},"reference-count":31,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T00:00:00Z","timestamp":1714089600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: This retrospective cohort study analyzes mechanical complications in hip fracture surgery using the Trochanteric Fixation Nail-Advanced (TFNA) implant. It investigates the correlation of these complications with demographic, intraoperative, and radiological factors, aiming to identify associated risk factors and suggest improvements in clinical surveillance and treatment strategies. Materials and Methods: We enrolled 253 patients diagnosed with pertrochanteric hip fractures treated between 2017 and 2021, with 126 meeting the criteria for a minimum 6-month follow-up. Data on demographics, American Anesthesia Association Classification (ASA), comorbidities, AO\/OTA [AO (Arbeitsgemeinschaft f\u00fcr Osteosynthesefragen)\/OTA (Orthopedic Trauma Association)] fracture classification, procedural details, and time to failure were collected. Radiographs were evaluated for reduction quality, the tip\u2013apex distance (TAD), progressive varus deviation, and identification of mechanical complications. Statistical analysis was performed using SPSS software. Results: The predominant AO\/OTA fracture classification was 31A2 in 67 cases (52.7%). Reduction quality was deemed good or acceptable in 123 cases (97.6%). The mean time to failure was 4.5 months (range: 2.2\u20136). The average TAD was 18 mm (range: 1.2\u201336), with a mean progressive varus deviation of 2.44\u00b0 (range: 1.30\u20134.14). A good or acceptable reduction quality was observed in 97.6% of cases. Mechanical complications occurred in 21.4% of patients, with significant associations found with the lateral cortex fracture, use of a TFNA implant with a 130\u00b0 angle, open reduction, and absence of prior osteoporosis treatment. Conclusions: The study provides insights into mechanical complications in proximal femur fractures treated with the TFNA nail, emphasizing the need for enhanced clinical and radiographic surveillance, especially in patients without osteoporosis treatment. Our findings support the necessity for further clinical studies comparing these outcomes with other implant designs and underscore the importance of personalized treatment strategies to reduce complication rates.<\/jats:p>","DOI":"10.3390\/medicina60050718","type":"journal-article","created":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T09:26:02Z","timestamp":1714123562000},"page":"718","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Mechanical Complications of Proximal Femur Fractures Treated with Intramedullary Nailing: A Retrospective Study"],"prefix":"10.3390","volume":"60","author":[{"given":"Alvaro","family":"Lopez-Hualda","sequence":"first","affiliation":[{"name":"Orthopedic Surgery and Traumatology Service, Hospital Universitario Fundaci\u00f3n Alcorcon, 28922 Alcorc\u00f3n, Spain"},{"name":"Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Od\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esperanza Marin","family":"Garc\u00eda-Cabrera","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery and Traumatology Service, Hospital Universitario Fundaci\u00f3n Alcorcon, 28922 Alcorc\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Lobato-Perez","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery and Traumatology Service, Hospital Universitario Fundaci\u00f3n Alcorcon, 28922 Alcorc\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8755-0069","authenticated-orcid":false,"given":"Javier","family":"Martinez-Martin","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery and Traumatology Service, Hospital Universitario Fundaci\u00f3n Alcorcon, 28922 Alcorc\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1623-7681","authenticated-orcid":false,"given":"Giacomo","family":"Rossettini","sequence":"additional","affiliation":[{"name":"Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Od\u00f3n, Spain"},{"name":"Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, Tenerife, 38300 Canary Islands, Spain"},{"name":"Department of Human Neurosciences, University of Roma \u201cSapienza Roma\u201d, 00184 Rome, Italy"},{"name":"School of Physiotherapy, University of Verona, 37129 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7818-2209","authenticated-orcid":false,"given":"Massimiliano","family":"Leigheb","sequence":"additional","affiliation":[{"name":"San Gaudenzio Clinic (Monza Polyclinic Group), 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3239-7626","authenticated-orcid":false,"given":"Jorge Hugo","family":"Villafa\u00f1e","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Od\u00f3n, Spain"},{"name":"Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Od\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s40001-021-00556-0","article-title":"Management of Proximal Femur Fractures in the Elderly: Current Concepts and Treatment Options","volume":"26","author":"Fischer","year":"2021","journal-title":"Eur. 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