Comparison of the outcomes of the proximal femur plate (PFP) and proximal femoral nail (PFN) in a patient presenting with trochanteric femur fracture
Mannan, Muhammad Osama, Mohammad Mukhtar, Basit Shrivastava, Nayan Karim, Faisal Ahmad, Zawar Shan, Rehan Raza Akram, Muhammad Zeeshan Tayyab, Muhammad
Mannan, Muhammad
Osama, Mohammad
Mukhtar, Basit
Shrivastava, Nayan
Karim, Faisal
Ahmad, Zawar
Shan, Rehan Raza
Akram, Muhammad Zeeshan
Tayyab, Muhammad
Abstract
Objective:
This study aimed to compare the outcomes of proximal femoral nailing (PFN) and proximal femur plate (PFP) in patients with trochanteric fractures. The primary objective was to assess fracture union time, while secondary objectives included operative duration, surgical site infection (SSI), and length of hospital stay.
Study design:
This is a prospective comparative study. Setting and duration: The study was conducted at the Department of Orthopaedics, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from September 21, 2023, to September 20, 2024, following approval of the study synopsis by the College of Physicians and Surgeons Pakistan (CPSP).
Materials and methods:
A total of 60 patients who met the inclusion criteria and underwent surgical treatment for trochanteric fractures were enrolled. Patients were allocated to one of two groups based on the surgical procedure performed: Group A underwent PFN, and Group B underwent PFP. No randomization was performed; patients were assigned based on the procedure received. All fractures were classified according to the AO Foundation and Orthopaedic - Trauma Association (AO/OTA) 31-A system and categorized as stable or unstable. Postoperative outcomes were assessed at one, three, and four months, focusing on SSI, operative time, and fracture healing.
Results:
In the PFN group, patient ages ranged from 50 to 80 years (median: 60 years), while in the PFP group, the median age was 58 years. SSI occurred in two patients (6.7%) in the PFN group and in one patient (3.3%) in the PFP group (p = 0.500). The mean operative duration was significantly longer in the PFN group (79.10 ± 12.78 minutes) compared to the PFP group (64.13 ± 12.92 minutes) (p < 0.0001). Similarly, fracture healing time was longer in the PFN group (12.57 ± 1.79 weeks) compared to the PFP group (10.60 ± 1.10 weeks) (p < 0.0001). Stratified analyses confirmed that these differences were most evident in stable AO/OTA 31-A1 and selected A2 patterns.
Conclusion:
While SSI rates were similar between the groups, PFP demonstrated shorter operative time and earlier fracture union compared to PFN. These findings suggest that PFP may be considered in selected stable fracture patterns, particularly in resource-constrained settings, whereas PFN remains the preferred option for unstable fractures.
MIDER Authors
Date
2025-10-02
Type
Journal Article
Subject
fracture healing, trochanteric fracture, trochanteric fracture
Collections
Citation
Mannan M, Osama M, Mukhtar B, Shrivastava N, Karim F, Ahmad Z, Shan RR, Akram MZ, Tayyab M. Comparison of the Outcomes of the Proximal Femur Plate (PFP) and Proximal Femoral Nail (PFN) in a Patient Presenting With Trochanteric Femur Fracture. Cureus. 2025 Oct 2;17(10):e93745. doi: 10.7759/cureus.93745.
Journal / Source Title
Cureus
DOI
10.7759/cureus.93745
PMID
41185842
Publisher
Cureus, Inc.