Objective:

To compare the cost-effectiveness of PFNA and FHR treatments for femoral neck basicervical fractures in elderly patients, highlighting the significance of informed treatment decisions amid aging populations and limited medical resources.

Key Findings:

• PFNA had a lower CER compared to FHR (751.74 vs. 874.60 yuan/point, p = 0.002) among 28 matched pairs.
• QALY-based CER for PFNA was more favorable (72,875.25 vs. 82,761.68 yuan/QALY).
• FHR required an additional 328,318.00 yuan/QALY, exceeding China's willingness-to-pay (WTP) threshold.
• Both treatments achieved favorable clinical outcomes, with FHR showing faster early functional recovery.

Interpretation:

PFNA is more cost-effective for long-term recovery, while FHR may be preferable for patients prioritizing early functional recovery, emphasizing the trade-off between cost and recovery speed.

Limitations:

• Retrospective design may introduce selection bias.
• Short follow-up period limits long-term cost evaluation.
• Findings may not be generalizable beyond the studied population.
• Potential confounding factors may affect the results.

Conclusion:

Both PFNA and FHR can achieve favorable outcomes in elderly patients with femoral neck basicervical fractures, but PFNA is the preferred option for cost-effectiveness. Future studies should focus on long-term outcomes, indirect costs, and consider patient preferences in treatment decisions.