Abstract
Intertrochanteric fractures are common injuries in the elderly. Conventional intramedullary nails including Gamma 3 locking nail and proximal femoral nail antirotation (PFNA) were designed for unstable intertrochanteric fractures. The InterTan (IT) nail system, introduced in 2005, has been reported superior biomechanical and clinical outcomes compared with 1-screw nailing system. However, some recent studies have reported that IT did not improve functional recovery in patients with intertrochanteric fractures. Randomized controlled trials (RCTs) or prospective cohort studies were included in our meta-analysis. We used the PRISMA guidelines and Cochrane Handbook to evaluate the quality of included studies to ensure that the pooled data of our meta-analysis were reliable and veritable. Our pooled data analysis demonstrated that IT was as effective as the control group in terms of Harris Hip Score (HHS), blood loss, total complications, union time, length of hospital stay, revision rate, and fluoroscopy time. IT shows less implant cut-out rate and femoral fractures when compared with control groups.
Highlights
Intertrochanteric fractures are common injuries and often occurred in elderly patients
A randomized controlled trial (RCT) with five-years of follow-up demonstrated that the InterTan Nail (IT) only performed better in functional outcome and hospital stay the 6-month follow-up, 33/104 patients were available for the final 5 year follow-up and no significant differences were recorded between two groups[10]
816 citations were identified from electronic journals databases, of which 781 records were removed by primary screening
Summary
Intertrochanteric fractures are common injuries and often occurred in elderly patients. The dynamic hip screw (DHS) as an extra-medullary stabilization device has been the most widely used implant. Complications such as hip varus deformity, delayed union and loosen screws have been frequently reported with DHS fixation in unstable fractures[3,4]. The InterTan Nail (IT), using an integrated 2-screw system, provide increased stability and resistance to femoral head rotation and decrease cut-out rate when compared with the conventional intramedullary nails such as PFNA and Gamma nails. A prospective clinical study reported that IT showed better clinical outcomes including varus angle, union time, full weight bearing, and cut-out rate than PFNA with 1-year follow-up[9]. Investigate whether IT leads to better postoperative functional recovery for intertrochanteric fractures compared with the conventional intramedullary nails
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