TITLE:
Risk Factors for Failure of Minimally Invasive PFNA Internal Fixation in Elderly Patients with Intertrochanteric Femoral Fractures
AUTHORS:
Guishan Liang, Kequan Fu, Hongmi Guo, Xiaofei Wu
KEYWORDS:
Intertrochanteric Femoral Fracture, PFNA Internal Fixation, Risk Factors
JOURNAL NAME:
Surgical Science,
Vol.17 No.11,
November
11,
2026
ABSTRACT: Objective: To investigate the risk factors for failure of minimally invasive proximal femoral nail antirotation internal fixation in elderly patients with intertrochanteric femoral fractures, and to provide evidence for reducing the surgical failure rate and improving prognosis. Methods: A total of 230 elderly patients with intertrochanteric femoral fractures who underwent PFNA internal fixation at Zhanjiang First Hospital of Traditional Chinese Medicine from January 2019 to April 2024 were retrospectively included. According to whether internal fixation failure occurred postoperatively, the patients were divided into a control group (successful fixation, n = 199) and an observation group (fixation failure, n = 31). Univariate analysis was used to compare clinical data between the two groups. Variables with P Results: Univariate analysis showed significant differences between the two groups in age, AO fracture classification, reduction status, diabetes mellitus, and smoking history (P P Conclusion: Age, AO type 3 fracture, diabetes mellitus, and reduction quality are key factors influencing PFNA internal fixation failure in elderly patients with intertrochanteric femoral fractures. The nomogram prediction model based on these factors demonstrates good discrimination and calibration and may be used to identify high-risk patients preoperatively and guide individualized treatment decisions.