A retrospective review of 149 older adults with basicervical femoral-neck fractures treated using proximal femoral nail antirotation found mechanical complications in 17 patients (11.4%) and reoperation in 11 (7.4%). BMI, ASA grade 4, lateral angulation and anteromedial cortical support remained associated in multivariable analysis. These are risk markers, not proof that changing one factor prevents failure.
Key findings
- Mean age was 81±9 years; 123 were women and 26 men. Mechanical complications occurred in 11.4% and reoperation in 7.4%. Several univariable candidates narrowed to BMI, ASA grade 4, lateral angulation and AMCS at p
Why this matters globally
The findings may inform reduction checklists and risk communication for an uncommon fracture pattern, especially AMCS and lateral angulation, but multicentre validation is needed before thresholds or guidelines.
Thai researcher contribution
The Ramathibodi–Mahidol, Prapokklao and Thai hospital team generated real-world clinical evidence directly relevant to older patients treated in Thailand.
Limitations to consider
The single-centre retrospective design and only 17 events create overfitting and residual-confounding risk. Complete-follow-up selection may bias results, no alternative implant was compared, and radiographic measures may vary between raters.