InterTan nail versus Gamma3 nail for intramedullary nailing of unstable trochanteric fractures

Abstract

BackgroundTrochanteric fractures (TF) have become a major source of morbidity and mortality in elderly. We conducted this study to compare the outcomes of unstable trochanteric fractures treated with the InterTan nail and Gamma3 nail.MethodsBetween January 2008 and May 2013, patients aged 60 years or older with a diagnosis of unstable TF treated with InterTan nail or Gamma3 nail were included. Patients treated with InterTan nail were pair-matched to patients treated with Gamma3 nail in a 1:2 ratio. Radiographs were obtained at 1, 3, 6, and 12 months follow-up, and all implant position changes, complications, fixation failures and functional scores were recorded.ResultsEighty-seven patients were included in the InterTan nail group, and 174 pair-matched patients were included in the Gamma3 nail group. Preoperative scores were similar between the 2 groups. There are significant improvements postoperatively in both groups. The incidence of cut-out and femoral shaft fracture were significantly higher in the Gamma3 nail group than the InterTan nail group (P = 0.024 and P = 0.044, respectively). Patients treated with the InterTan nail experienced longer fluoroscopy and operative times.ConclusionsThe InterTan nail may have a tendency in better outcomes for patients with unstable TF. However, the limited period of follow-up and inherent defects of nonrandomized trials indicate that better-designed randomized controlled trials will be required.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_191

Learning Curve and Clinical Outcomes of Performing Surgery with the InterTan Intramedullary Nail in Treating Femoral Intertrochanteric Fractures

“…The mean duration of surgery for InterTan intramedullary nail in the late group of patients was 64.97 (95% CI 59.59 to 70.36) min, similar to the operative time reported in earlier research that ranged from 48 to 73.91 min [4, 5, 15, 18–20], excluding one study that reported an average time that was less than 30 minutes [21]. These studies also reported that the mean operative time for GN, PFNA, or PFNA-II treatments [4, 5, 15, 18–20] was 44.41–72.98 minutes.…”

“…These studies also reported that the mean operative time for GN, PFNA, or PFNA-II treatments [4, 5, 15, 18–20] was 44.41–72.98 minutes. Of these, two studies reported that there was no significant difference in the operative time between the InterTan intramedullary nail (IT) group and the GN or PFNA group [15, 20].…”

Comparison of clinical outcomes with InterTan vs Gamma nail or PFNA in the treatment of intertrochanteric fractures: A meta-analysis

“…A previous clinical study reported that IT showed good clinical outcome and low complication rate in Asian patients 26 . However, when compared with 1-screw nailing system, patients treated with the IN nail showed similar HHS and experienced longer fluoroscopy and operative time 19 . It was not clear whether IT can provide better clinical outcomes.…”

Biomechanics of Osteoporotic Fracture Fixation

“…For extremely unstable fracture situations, cerclage wiring or auxiliary plates have shown to improve biomechanical stability [26]. It appears that these biomechanical findings translate well into clinical practice [26,27].…”