InterTAN versus proximal femoral nail anti-rotation for intertrochanteric fractures in the elderly:a comparison of joint function and stability

He Yun; Yiliyaer·Abudusimu; Xu Bin; Wang Guosheng

doi:10.12307/2026.622

Abstract：BACKGROUND:Elderly patients with intertrochanteric fractures often have multiple medical comorbidities and significant osteoporosis,posing considerable challenges for treatment.Proximal femoral nail anti-rotation and InterTAN are both commonly used intramedullary fixation systems.However,there remains insufficient evidence regarding the optimal selection of fixation systems for patients with different medical conditions and fracture types. OBJECTIVE:To compare the clinical outcomes and complication differences between integrated compression screw and lag screw intertrochanteric nail(InterTAN)and proximal femoral nail anti-rotation in the treatment of elderly patients with intertrochanteric fractures. METHODS:A prospective randomized controlled trial was conducted.A total of 118 elderly patients with intertrochanteric fractures who met the inclusion criteria were enrolled.Patients were randomly divided into groups.The proximal femoral nail anti-rotation group(59 cases)underwent internal fixation with proximal femoral nail anti-rotation,and the InterTAN group(59 cases)underwent internal fixation with InterTAN.Perioperative parameters,including operation time,intraoperative blood loss,fluoroscopy frequency,and hospital stay,were recorded.Follow-up assessments were conducted at 1,3,6,and 12 months postoperatively.The fracture healing rate,internal fixation stability,and complications were evaluated using Harris hip scores and imaging examinations. RESULTS AND CONCLUSION:(1)Operation time,intraoperative blood loss,and fluoroscopy frequency in the proximal femoral nail anti-rotation group were significantly lower than those in the InterTAN group(P<0.001).No significant difference was found in hospital stay(P>0.05).(2)The fracture healing rates were similar between the two groups at 12-month follow-up(P>0.05).At 12 months,the incidence of instability was significantly lower in the InterTAN group(P<0.05).Harris scores in terms of pain,function,and joint mobility in the InterTAN group were significantly superior to those in the proximal femoral nail anti-rotation group(P<0.05).There was no significant difference in overall complication rates between the two groups(P>0.05).(3)These results indicate that proximal femoral nail anti-rotation has certain advantages in reducing perioperative trauma,whereas InterTAN demonstrates greater potential value in terms of fixation stability and functional recovery at the 1-year follow-up.Clinical selection of internal fixation systems should be based comprehensively on the patient's condition and fracture type.