The Proximal Femoral Nail Versus the Proximal Femoral Locked Plate for Fixation of Unstable Proximal Femoral Fracture

Abstract

Background: Unstable proximal femur fractures are common in elderly patients and are related to high death and morbidity. Surgical fixation aims to achieve stability, permit early mobilization, and minimize complications.

Objective: To compare the functional and radiological outcomes of proximal femoral nail (PFN) fixation and proximal femoral locking compression plate (PFLCP) fixation in unstable proximal femur fractures.

Methods: This prospective comparative research has been on 46 cases with unstable proximal femur fractures treated at Badr University Hospital between November 2022 and November 2023. Patients were separated into two groups: Group A treated with PFN (n=23) and Group B with PFLCP (n=23). Outcomes assessed included operative parameters, fracture union time, functional recovery (Harris Hip Score), hospital stay, and complications.

Results: PFN fixation was associated with shorter operative time, less intraoperative blood loss and smaller incision length compared with PFLCP. Time to fracture union was significantly shorter in the PFN group. Functional outcomes were comparable, with good-to-excellent Harris Hip Scores in 82.5% of PFN cases and 73.9% of PFLCP cases. Complication rates, including infection, nonunion, and limb shortening, were similar between groups.

Conclusion: PFN offers a less invasive technique with reduced blood loss, shorter surgery, and faster union compared with PFLCP, while both methods provide comparable functional outcomes and complication rates. PFN is therefore preferable for unstable proximal femur fractures, particularly in elderly patients.