Key result
InterTAN internal fixation resulted in significantly higher Harris hip joint scores at 12 months compared to PFNA (85.56 vs 79.86, p<0.001), indicating better postoperative functional recovery despite longer operation times.
Why the study?
To compare clinical outcomes of InterTAN nail versus proximal femoral nail antirotation internal fixation for treating intertrochanteric fractures in elderly patients.
Does InterTAN compared to PFNA improve clinical outcomes and functional recovery in elderly patients with intertrochanteric fracture?
Cohort (n=151)
No
Does InterTAN compared to PFNA improve clinical outcomes and functional recovery in elderly patients with intertrochanteric fracture?
In elderly patients with intertrochanteric fractures, InterTAN provides better postoperative hip joint functional recovery, while PFNA results in less perioperative surgical trauma.
Should not yet change fixation choice; leaves open need for RCTs to confirm functional benefits in elderly fractures.
Objective: To compare the clinical outcomes of InterTAN nail and proximal femoral nail antirotation (PFNA) internal fixation for the treatment of intertrochanteric fractures in the elderly. Methods: We retrospectively reviewed the clinical records of 151 elderly patients with intertrochanteric fractures treated in The Second People’s Hospital of Hefei from October 2019 to December 2021. Among them, 73 patients had undergone InterTAN (InterTAN group) and 78 patients had undergone PFNA (PFNA group) internal fixation. Operation-related variables (operation time, incision length, intraoperative bleeding volume, hospital stays length, and fracture healing time), complications, and Harris scores were compared between the two groups. Results: The operation time and incision length were shorter and the intraoperative bleeding was less in the PFNA group than in the InterTAN group (all P-values <0.05), but the fracture healing time was longer in the PFNA group (P<0.05). We found similar hospital stays and surgical complications in the two groups (P>0.05). In addition, the Harris hip joint scores were significantly higher in the InterTAN group than in the PFNA group at one, six, and twelve months after the operation (P<0.05). Conclusions: InterTAN and PFNA internal fixation have their own advantages in treating patients with intertrochanteric fractures. InterTAN has better postoperative recovery results, while PFNA has less perioperative trauma. Clinically, InterTAN or PFNA should be selected based on the specific conditions of each patient to maximize the therapeutic benefit of each treatment method. doi: https://doi.org/10.12669/pjms.40.4.8794 How to cite this: Li L, Fang X, Gao J, Han W, Kong X. Comparison of InterTAN and PFNA internal fixation for elderly patients with intertrochanteric fracture: a retrospective cohort study. Pak J Med Sci. 2024;40(4):589-594. doi: https://doi.org/10.12669/pjms.40.4.8794 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Li et al. (2024) conducted a cohort in Intertrochanteric fracture (n=151). InterTAN internal fixation vs. PFNA internal fixation was evaluated on Harris hip joint score at 12 months (p=<0.001). InterTAN internal fixation resulted in significantly higher Harris hip joint scores at 12 months compared to PFNA (85.56 vs 79.86, p<0.001), indicating better postoperative functional recovery despite longer operation times.
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