Gold wrist-assisted PFNA reduces internal complications and enhances recovery in obese osteoporotic patients with intertrochanteric femur fractures

Zhonghan Wu, Jianyang Li, Shitan Mao, Jingtao Lu, Yao Zhao, Shuisheng Yu, Dasheng Tian, Juehua Jing, Rongguang Ao and Xinzhong Xu

PLOS ONE, 2026, vol. 21, issue 7, 1-14

Abstract: Introduction: Obese, osteoporotic patients with intertrochanteric fractures face higher surgical risks and delayed recovery. The “Gold Wrist,” an auxiliary curved guiding instrument for proximal femoral nail anti-rotation (PFNA), was developed to assist guidewire placement and improve procedural efficiency. Methods: In this retrospective cohort study, 500 patients (almost all with BMI > 28 and varying degrees of osteoporosis) underwent PFNA using either the Gold Wrist (n = 250) or conventional instruments (n = 250). Outcomes included operative time, fluoroscopy exposure, incision length, inflammatory markers, functional recovery, internal medicine complications, mechanical complications, hospitalization cost, and estimated carbon footprint. Finite element analysis assessed device mechanical stability. Results: Finite element analysis confirmed reliable mechanical performance. The Gold Wrist group had shorter operative time (114.7 ± 34.6 vs. 127.3 ± 34.3 min), smaller incisions (6.15 ± 1.88 vs. 7.27 ± 1.79 cm), and lower TNF-α, IL-6, CRP, and CK levels (all P

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0348432

DOI: 10.1371/journal.pone.0348432

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