Horizontal positioning for accurate lateral helical blade insertion in proximal femoral nail antirotation (PFNA) for elderly osteoporotic patients
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective 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. Methods 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. Results A total of 86 patients participated in the study (HP group: n = 46; TLV group: 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 ( 1 – 3 ) vs. 3 ( 2 – 5 ) min, p < 0.001] and required fewer intraoperative lateral fluoroscopy images [1 ( 1 – 3 ) vs. 3 ( 2 – 6 ), p < 0.001]. The horizontal anteversion angle in the HP group was 6.4 ± 6.3°. The success rate of one-time lateral pin placement was higher in the HP group (95.7 vs. 85.0%, p = 0.138). No significant differences were found between two groups concerning reduction quality or spiral blade position and short-term post-operative complications. Conclusion HP technology may enhance surgical efficiency and reduce radiation exposure while maintaining surgical safety and the accuracy of nail placement.
Source: Frontiers in Medicine
Institution: Nankai University
Language: English
Topic: Hip and Femur Fractures
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7129247270