Comparative Analysis of Radiologic Outcomes and Mechanical Complications Associated with Four Different Proximal Femoral Nail Designs

Aim: This study aimed to retrospectively assess the efficacy of four commonly used Proximal Femoral Nail (PFN) designs in the surgical treatment of hip fractures, focusing on factors that influence patient outcomes. Patients and Methods: We evaluated 220 patients treated for extracapsular hip fractures with different PFN designs from January 1, 2017, to January 1, 2023. We reviewed patient demographics, comorbidities, anesthesia type, operative details, and postoperative radiographs. Results: A cohort of 220 patients was analyzed. Of these, 138 were female, and 82 were male. Patients were divided into four groups based on the type of PFN used. Group 1 (double lag screw PFN) had the best radiological outcomes with superior reduction quality and fewer complications. The groups showed no significant differences in terms of age, gender, type of anesthesia, or comorbidities. However, Group 3 (Intertan PFN) had a lower tip-apex distance, and Group 1 showed the fewest complications overall. Conclusion: This study demonstrates that the use of PFN with double lag screws in extracapsular hip fractures is associated with superior fracture reduction, fewer complications, and a lower incidence of nonunion.