The Treatment of Intertrochanteric Fractures: Results Using an Intramedullary Nail With Integrated Cephalocervical Screws and Linear Compression

Abstract

The InterTan device appears to be a reliable implant for the treatment of intertrochanteric femoral fractures. Its design provides for stability against rotation and minimizes neck malunions (shortening) through linear intraoperative compression of the head/neck segment to the shaft. As a result of the negligible complication rate and improved clinical outcomes, this implant is now the standard treatment for all intertrochanteric fractures at our institution.

TRIGEN INTERTAN Intramedullary Nail Versus Sliding Hip Screw

“…In a prospective study on patients treated with the INTERTAN nail, Ruecker et al 8 reported two implant cutouts in forty-eight patients with one year of followup. In the present study, implant cutout was the most common cause of failure of the osteosynthesis, but we found no significant difference between the treatment groups.…”

“…The TRIGEN INTERTAN nail (Smith & Nephew, Memphis, Tennessee) was recently introduced, and according to the manufacturer the shape of the nail should enhance stability and offer greater resistance to implant cutout 7 . Ruecker et al 8 reported good clinical results in a study on their first 100 patients treated with an INTERTAN nail. However, we are not aware of any study comparing the INTERTAN nail with a sliding hip screw.…”

Comparison of Two Types of Proximal Femoral Nails in the Treatment of Intertrochanteric Femur Fractures

“…Ruecker et al have evaluated the outcomes of patients fixed with Intertan PFNs to treat ITF and reported varus collapse in two of 48 patients, although both had TAD values <5 mm on AP radiographs. [18] In the study of Zhang et al, InterTAN and proximal femoral nail antirotation (PFNA) have been compared. The results have shown that the extent of shortening at the femoral neck is greater in the InterTAN than in the PFNA group, whereas all of the union rate, walking ability, Harris hip score, and hip range of motion, have been similar between the two groups.…”

Radiologic healing of lateral femoral wall fragments after intramedullary nail fixation for A3.3 intertrochanteric fractures

“…However, applying a TSP causes additional soft tissue dissection, bleeding, and increased surgical time. Cephalomedullary nailing is a useful option for these 31 A3.3 fractures, because the nail itself acts as a lateral buttress and prevents excessive sliding of the proximal fragment or medial translation of the distal shaft fragment [10][11][12][13]. In spite of this potential advantage of a nail over a dynamic hip screw, there is concern regarding the stability and healing of the free LFW fragment that cannot be stabilized by nailing.…”