Retrospective comparison between helical blade and screw in geriatric hip fracture fixation with cephalomedullary devices

Introduction Cephalomedullary device is a well-established method for trochanteric hip fracture fixation. This study investigated the fracture union rate, fixation failure rate and clinical outcomes of TFN-ADVANCED Proximal Nailing (TFNA) helical blade versus screw. Method This retrospective cohort study involved 180 geriatric extracapsular hip fracture cases fixed with TFNA from January 2024 to September 2025. The primary outcome was fracture union rate at 6 months and fixation failure rate. Secondary clinical outcomes were intra-operative blood loss, length of hospital stay, post-operative functional status, and mortality rate. Results There was no significant difference between TFNA helical blade and screw in terms of fracture union rate and fixation failure rate. Secondary clinical outcomes were comparable for both groups. Fracture reduction quality was identified as an independent risk factor for fixation failure. Conclusions TFNA helical blade and screw have no significant difference in fracture union rate at 6 months and fixation failure rate.