Key result
Compared to PFNA and PFNA-II, InterTan internal fixation demonstrated advantages in reducing screw cut-out, femoral shaft fractures, and secondary operations in elderly patients with unstable intertrochanteric fractures.
Why the study?
Controversy remains regarding the clinical effects of treatments for unstable intertrochanteric fractures in elderly individuals, who often experience poor stability after fracture reduction.
Does InterTan internal fixation improve clinical outcomes and reduce complications compared to PFNA and PFNA-II in elderly patients with unstable intertrochanteric fractures?
Meta-Analysis (n=1,236)
Does InterTan internal fixation improve clinical outcomes and reduce complications compared to PFNA and PFNA-II in elderly patients with unstable intertrochanteric fractures?
Odds Ratio: 6.01 (95% CI 2.81–12.85)
p-value: p=<0.00001
InterTan internal fixation may reduce postoperative complications like screw cut-out and femoral shaft fractures compared to PFNA/PFNA-II in elderly patients with unstable intertrochanteric fractures, despite longer procedural times.
InterTan may offer advantages for unstable intertrochanteric fractures; leaves open need for randomized confirmation.
Elderly individuals are often affected by osteoporosis and have poor stability after fracture reduction. Moreover, there is still controversy regarding the clinical effects of the treatment for unstable intertrochanteric fractures in the elderly. The Cochrane, Embase, PubMed, and other databases were searched, and a meta-analysis of the literature on the treatment of unstable intertrochanteric fractures of the elderly with InterTan, PFNA, and PFNA-II was conducted. Seven studies were screened, with a total of 1236 patients. Our meta-analysis results show that InterTan is not significantly different from PFNA in terms of operation and fluoroscopy times, but it takes longer than PFNA-II. In terms of postoperative screw cut, pain, femoral shaft fracture, and secondary operations, InterTan is superior to PFNA and PFNA-II. Conversely, in terms of intraoperative blood loss, hospital stay, and postoperative Harris score, there is no significant difference between InterTan and PFNA and PFNA-II. Compared to PFNA and PFNA-II, InterTan internal fixation has advantages in the treatment of unstable intertrochanteric fractures in elderly individuals in terms of screw cutting, femoral shaft fractures, and secondary operations. However, InterTan operation and fluoroscopy times take longer than PFNA and PFNA-II.
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Wang et al. (2023) conducted a meta-analysis in Unstable intertrochanteric fractures (n=1,236). InterTan internal fixation vs. PFNA and PFNA-II was evaluated on Postoperative screw cut-out (OR 6.01, 95% CI 2.81-12.85, p=<0.00001). Compared to PFNA and PFNA-II, InterTan internal fixation demonstrated advantages in reducing screw cut-out, femoral shaft fractures, and secondary operations in elderly patients with unstable intertrochanteric fractures.
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