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July 23, 2026Scientific ReportsOpen Access

Proximal Femoral Bionic Nail linked to ~80% lower implant failure risk versus PFNA.

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Why the study?

To compare clinical efficacy and implant survival between the Proximal Femoral Bionic Nail and Proximal Femoral Nail Antirotation in elderly patients with unstable intertrochanteric femoral fractures.

Does the Proximal Femoral Bionic Nail (PFBN) improve clinical efficacy and implant survival compared to the Proximal Femoral Nail Antirotation (PFNA) in elderly patients with unstable intertrochanteric fractures?

Population

173 patients aged ≥ 65 years with unstable intertrochanteric fractures

Comparison

Proximal Femoral Bionic Nail vs Proximal Femoral Nail Antirotation

Design

Prospective propensity score-matched cohort study

Follow-up

1 year

Key result

The Proximal Femoral Bionic Nail reduced implant failure compared to PFNA (4.2% vs. 20.8%, P=0.027), though differences in functional recovery and 1-year Harris Hip Score lacked clinical relevance.

Authors

XXXiaohui XiongWLWeifei LianTWTianwang Wu

Discussion

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Overview

PFBN was associated with lower implant failure but lacked clinical significance; leaves open need for RCTs to assess meaningful benefit.

Key Points

  • To compare the clinical efficacy and implant survival of PFBN and PFNA in elderly patients with unstable intertrochanteric fractures.
  • One-to-one propensity score matching was used to balance baseline characteristics in 173 enrolled patients.
  • Key outcomes analyzed included VAS pain scores, Harris Hip Scores, complications, and implant survival.
  • Patients aged ≥ 65 years with unstable intertrochanteric fractures (AO/OTA 31-A2.2 or higher) were included.
  • The PFBN group had significantly lower implant failure rates (4.2% vs. 20.8%, P = 0.027).
  • Patients in the PFBN group ambulated earlier postoperatively (P = 0.022).
  • At 6 months, the HHS was significantly higher in the PFBN group (P = 0.015), but differences were below clinical significance.

Study Design

Type

Cohort (n=173)

Structured PICO

Does the Proximal Femoral Bionic Nail (PFBN) improve clinical efficacy and implant survival compared to the Proximal Femoral Nail Antirotation (PFNA) in elderly patients with unstable intertrochanteric fractures?

P
Population
173 patients aged ≥ 65 years with unstable intertrochanteric femoral fractures, analyzed using propensity score matching with 1-year follow-up.
E
Exposure
Proximal Femoral Bionic Nail (PFBN)
C
Comparator
Proximal Femoral Nail Antirotation (PFNA)
O
Outcome
Clinical efficacy (Visual Analogue Scale pain scores, Harris Hip Score), complications, and implant survivalpatient reported

Main Result

Absolute Event Rate: 4.2% vs 20.8%

p-value: p=0.027

PFBN reduces implant failure and allows earlier ambulation compared to PFNA in elderly patients with unstable intertrochanteric fractures, though long-term functional differences are not clinically significant.

Cite This Study

Xiong et al. (2026) conducted a cohort in unstable intertrochanteric femoral fractures (n=173). Proximal Femoral Bionic Nail (PFBN) vs. Proximal Femoral Nail Antirotation (PFNA) was evaluated on implant failure (p=0.027). The Proximal Femoral Bionic Nail reduced implant failure compared to PFNA (4.2% vs. 20.8%, P=0.027), though differences in functional recovery and 1-year Harris Hip Score lacked clinical relevance.

synapsesocial.com/papers/6a61b02ffaa9903c5116acd6https://doi.org/10.1038/s41598-026-59814-y
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Proximal femoral bionic nail (PFBN) versus InterTAN nail for intertrochanteric femoral fractures in elderly patients: a systematic review and meta-analysis2026
  2. 2CLINICAL, FUNCTIONAL AND RADIOLOGICAL OUTCOMES OF PROXIMAL FEMUR NAIL (PFN) IN COMPARISON WITH PROXIMAL FEMUR NAIL ANTIROTATION FOR ASIANS (PFNA2) IN THE TREATMENT OF INTERTROCHANTERIC FEMUR FRACTURE2024
  3. 3Intertrochanteric Fractures Treated with Proximal Femoral Bionic Nail versus Proximal Femoral Nail Antirotation versus InterTan Nail: A Meta-analysis2026
  4. 4Functional and radiological outcome in unstable intertrochanteric femur fractures – PFN versus PFNA2 and its implication in less educated and low socioeconomic patients2025 · 1 citations
  5. 5Comparative Study of the Clinico-Radiological Outcomes of Fixation of Unstable Intertrochanteric Fractures with Standard Proximal Femoral Nail (PFN) and Proximal Femoral Nail Antirotation for Asia (PFNA2)2024 · 1 citations