Key result
Trigen InterTAN nail linked to better clinical scores and fewer complications versus A-PFN and PROFIN.
Why the study?
The study was conducted to evaluate the radiological and functional outcomes of closed reduction and internal fixation for intertrochanteric femoral fractures using three different proximal femoral nails.
Does the InterTAN nail improve clinical and radiological outcomes compared to A-PFN and PROFIN nails in patients with intertrochanteric femoral fractures?
Observational (n=309)
Does the InterTAN nail improve clinical and radiological outcomes compared to A-PFN and PROFIN nails in patients with intertrochanteric femoral fractures?
The InterTAN nail provides better clinical scores and lower complication rates (no Z-effect, low V-effect) compared to A-PFN and PROFIN nails for intertrochanteric femoral fractures.
Answers are grounded in this paper and cite their sources.
Should not yet change practice; hypothesis-generating for InterTAN advantages pending randomized trials.
Background and Objectives: The aim of this study was to evaluate retrospectively the radiological and functional outcomes of closed reduction and internal fixation for intertrochanteric femoral fractures (IFF) using three different proximal femoral nails (PFN). Materials and Methods: In total, 309 individuals (143 males and 166 females) who underwent surgery for IFF using a PFN between January 2018 and January 2021 were included in the study. Our surgical team conducted osteosynthesis using the A-PFN® (TST, Istanbul, Turkey) nail, the PROFIN® (TST, Istanbul, Turkey), and the Trigen InterTAN (Smith & Nephew, Memphis, TN, USA) nail. The PFNs were compared based on age, gender, body mass index (BMI), length of stay (LOS) in intensive care, whether to be admitted to intensive care, mortality in the first year, amount of transfusion, preoperative time to surgery, hospitalisation time, duration of surgery and fluoroscopy, fracture type and reduction quality, complication ratio, and clinical and radiological outcomes. The patients’ function was measured with the Harris Hip Score (HHS) and the Katz Index of Independence in Activities of Daily Living (ADL). Results: Pain in the hip and thigh is the most common complication, followed by the V-effect. The Z-effect was seen in 5.7% of PROFIN patients. A-PFN was shown to have longer surgical and fluoroscopy durations, lower HHS values, and much lower Katz ADL Index values compared to the other two PFNs. The V-effect occurrence was significantly higher in the A-PFN group (36.7%) than in the InterTAN group. The V-effect was seen in 33.1% of 31A2-type fractures but in none of the 31A3-type fractures. Conclusions: InterTAN nails are the best choice for IFFs because they have high clinical scores after surgery, there is no chance of Z-effect, and the rate of V-effect is low.
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Yalın et al. (2023) conducted an observational in Intertrochanteric femoral fractures (n=309). Trigen InterTAN nail vs. A-PFN and PROFIN nails was evaluated on Radiological and functional outcomes (Harris Hip Score, Katz Index, and complications). The Trigen InterTAN nail provided higher clinical scores and lower complication rates, with no Z-effect and lower V-effect compared to A-PFN (36.7%) and PROFIN (5.7% Z-effect) for femoral fractures.
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