The CHINA TFNA Study

Inclusion criteria

• Age ≥18 years
• Patients with unilateral proximal femur fractures that will be treated with intramedullary nail internal fixation
• According to AO fracture classification, subjects with following fracture type:

• Pertrochanteric (31-A1 and 31-A2)
• Intertrochanteric (31-A3)
• Trochanteric area (31-A1/A2/A3) with diaphyseal extension
• Subject must be comfortable with speaking and understanding questions and responses in an available translated language for patient reported outcomes (PROs)

Exclusion criteria

• Subject does not provide voluntary consent to participate in the study
• The subject is a woman who is pregnant or lactating
• Fractures where the operative treatment will occur more than three weeks after the primary injury
• Patients with femoral head fractures and femoral neck fractures (AO classification 31-B and 31-C)
• Pathological fracture (e.g., primary or metastatic tumor)
• Serious soft tissue injury, judged by the investigator, will impact the union of the fracture, combined vascular injury, and combined osteofascial compartment syndrome
• Multiple systemic injuries judged by researchers not suitable for enrollment, or orthopaedic fractures in other bones at three or more sites
• Revision surgeries (for example, due to malunion, nonunion or infection)
• Concurrent medical conditions judged by researchers not suitable for enrollment, such as: diabetes, metabolic bone disease, post-polio syndrome, poor bone quality, prior history of poor fracture healing, etc
• Patients with anaesthetic and surgical contraindications
• Patients known to be allergic to implant components
• Patients who are currently using chemotherapeutics or accepting radiotherapy, use systematically corticosteroid hormone or growth factor, or long-term use sedative hypnotics (continuous use over 3 months) or non-steroidal anti-inflammatory drugs (continuous use over 3 months)
• Intemperance judged by researchers not suitable for enrollment (e.g., excessive daily drinking or smoking, drug abuse);
• Patients participated into other clinical trial in the previous 3 months;
• Patients with bad compliance judged by researchers and cannot complete the test according to test scheme, such as schizophrenia and dementia.