Comparison of clinical and radiological outcomes in intertrochanteric fractures treated with InterTAN nail against conventional cephalomedullary nails: a systematic review

Abstract

Intertrochanteric fractures, accountable for 50% of hip fractures, can be fixed with cephalomedullary devices such as Proximal Femoral Nail Anti-rotation (PFNA™), Gamma3 Nailing System and TRIGEN™ InterTAN™ nail (IT). IT uniquely uses two cephalocervical screws which allow for linear compression and provide additional resistance to femoral head rotation. A literature review assessing clinical outcomes of these devices was conducted, with fourteen studies enrolling 3104 patients meeting the inclusion criteria. PFNA and Gamma3 had better intraoperative outcomes compared with IT, however IT had superior implant-related outcomes of cut-out and screw migration. No difference was found between IT and PFNA or Gamma3 in Harris Hip Scores (HHS), time to union, malunion and non-union. Further long-term studies are needed to evaluate clinical outcomes and cost-effectiveness of cephalomedullary devices.