Sa1.3 Relation of cephalocervical screw placement and correction loss in intertrochanteric fractures treated with INTERTAN nail

Intertrochanteric fractures, accountable for 50% of hip fractures, can be fixed with cephalomedullary devices such as Proximal Femoral Nail Antirotation (PFNA™), Gamma3 nailing system and TRIGEN™ InterTAN™ nail (IT). IT uniquely uses two cephalocervical screws that allow for linear compression and provide additional resistance to femoral head rotation. A literature review assessing clinical outcomes of these devices was conducted, with 14 studies enrolling 3104 patients meeting the inclusion criteria. PFNA and Gamma3 had better intraoperative outcomes compared with IT; however, IT had superior implant-related outcomes of cut-out and screw migration. No difference was found between IT and PFNA or Gamma3 in Harris Hip Scores, time to union, malunion and nonunion. Further long-term studies are needed to evaluate clinical outcomes and cost–effectiveness of cephalomedullary devices.

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Tip apex distance, hip screw placement, and neck shaft angle as potential risk factors for cut-out failure of hip screws after surgical treatment of intertrochanteric fractures

International Orthopaedics ◽

10.1007/s00264-012-1636-0 ◽

2012 ◽

Vol 36 (11) ◽

pp. 2347-2354 ◽

Cited By ~ 71

Author(s):

Hagen Andruszkow ◽

Michael Frink ◽

Cornelia Frömke ◽

Amir Matityahu ◽

Christian Zeckey ◽

...

Keyword(s):

Risk Factors ◽

Surgical Treatment ◽

Potential Risk ◽

Screw Placement ◽

Intertrochanteric Fractures ◽

Neck Shaft Angle ◽

Potential Risk Factors ◽

Shaft Angle ◽

Hip Screw ◽

Tip Apex Distance

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Biomechanical Comparison of INTERTAN Nail and Gamma3 Nail for Intertrochanteric Fractures

Orthopaedic Surgery ◽

10.1111/os.12853 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1990-1997

Author(s):

Wei Luo ◽

Xin Fu ◽

Jian‐xiong Ma ◽

Jing‐min Huang ◽

Jiang Wu ◽

...

Keyword(s):

Intertrochanteric Fractures ◽

Biomechanical Comparison ◽

Gamma3 Nail ◽

Intertan Nail

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A new technique for lag screw placement in the dynamic hip screw fixation of intertrochanteric fractures: decreasing radiation time dramatically

International Orthopaedics ◽

10.1007/s00264-008-0517-z ◽

2008 ◽

Vol 33 (2) ◽

pp. 537-542 ◽

Cited By ~ 3

Author(s):

Wei-Chao Sheng ◽

Jia-Zhen Li ◽

Sheng-Hua Chen ◽

Shi-Zhen Zhong

Keyword(s):

Screw Fixation ◽

Dynamic Hip Screw ◽

New Technique ◽

Screw Placement ◽

Intertrochanteric Fractures ◽

Lag Screw ◽

Hip Screw ◽

A New Technique ◽

Radiation Time

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Comparison of clinical outcomes with proximal femoral nail anti-rotation versus InterTAN nail for intertrochanteric femoral fractures: A meta-analysis

10.21203/rs.3.rs-21889/v1 ◽

2020 ◽

Author(s):

Wei Liu ◽

Guangrong Ji ◽

Jie Liu

Keyword(s):

Observational Studies ◽

Femoral Shaft Fracture ◽

Femoral Shaft ◽

Shaft Fracture ◽

Proximal Femoral Nail ◽

Harris Hip Score ◽

Intertrochanteric Fractures ◽

Femoral Nail ◽

Tip Apex Distance ◽

Intertan Nail

Abstract Objective: To access the efficacy and safety of proximal femoral nail anti-rotation (PFNA) and InterTAN nail for intertrochanteric femoral fractures.Methods: According to the Cochrane systemic analysis method, randomized control trials (RCTs) and retrospective comparative observational studies which were related to the comparison of PFNA and InterTAN nail in the treatment of the elderly with intertrochanteric fractures were retrieved. Data were independently extracted from the included studies by two reviewers and analyzed using RevMan 5.3 , and the quality of the studies was assessed.Results: Two RCTs and seven observational studies were recruited, which consisted of 681 patients with PFNA and 651 patients with InterTAN nail. The meta-analyses showed no significant differences between the two approaches on Harris Hip Score, operation time, blood loss, time to union, mean hospital stay, union problems, intraoperative complications, hematoma, infection, other complication in both RCTs and observational studies. In terms of other outcomes, for the RCTs, results showed that there were shorter tip–apex distance, reduced pain at thigh or hip in InterTAN nail than in PFNA; however, InterTAN nail was not superior to PFNA in cutout, reoperation, and femoral shaft fracture; for observational studies, the risk of the screw migration (RR=5.13, 95%CI: [1.33,19.75], P=0.02), cutout (RR=3.26, 95%CI: [1.64,6.47], P=0.0008), the varus collapse of the femoral head (RR=7.19, 95%CI: [2.18,23.76], P=0.001), femoral shaft fracture (RR=5.73, 95%CI: [2.24,14.65], P=0.0003) treated by InterTAN nail were significantly decreased, compared with those by PFNA; however, no significant differences was observed in the aspects of tip–apex distance and pain at thigh or hip between these two groups.Conclusion: Analysis of a large number of relevant clinical indicators available shows that InterTAN nail has better clinical manifestation than PFNA in treating unstable femoral intertrochanteric fractures.

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Comparison of clinical outcomes with proximal femoral nail anti-rotation versus InterTAN nail for intertrochanteric femoral fractures: a meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-02031-8 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Wei Liu ◽

Jie Liu ◽

Guangrong Ji

Keyword(s):

Observational Studies ◽

Femoral Shaft Fracture ◽

Meta Analysis ◽

Femoral Fractures ◽

Femoral Shaft ◽

Shaft Fracture ◽

Proximal Femoral Nail ◽

Intertrochanteric Fractures ◽

Tip Apex Distance ◽

Intertan Nail

Abstract Background A meta-analysis to access the pros and cons of proximal femoral nail anti-rotation (PFNA) versus InterTAN nail for intertrochanteric femoral fractures including available evidence extracted from literature. Methods According to the Cochrane systemic analysis method, randomized control trials (RCTs) and retrospective comparative observational studies which were related to the comparison of PFNA and InterTAN nail in the treatment of the elderly with intertrochanteric fractures were retrieved. Data were independently extracted from the included studies by two reviewers and analyzed using RevMan 5.3, and the quality of the studies was assessed. Results Two RCTs and seven observational studies were recruited, which consisted of 681 patients with PFNA and 651 patients with InterTAN nail. The meta-analyses showed no significant differences between the two approaches on Harris Hip Score, operation time, blood loss, time to union, mean hospital stay, union problems, intraoperative complications, hematoma, infection, and other complications in both RCTs and observational studies. In terms of other outcomes, for the RCTs, results showed that there were shorter tip–apex distance and reduced pain at thigh or hip in InterTAN nail than in PFNA; however, InterTAN nail was not superior to PFNA in cutout, reoperation, and femoral shaft fracture; for observational studies, the risk of the screw migration (RR = 5.13, 95%CI [1.33,19.75], P = 0.02), cutout (RR = 3.26, 95%CI [1.64,6.47], P = 0.0008), the varus collapse of the femoral head (RR = 7.19, 95%CI [2.18,23.76], P = 0.001), femoral shaft fracture (RR = 5.73, 95%CI [2.24,14.65], P = 0.0003) treated by InterTAN nail were significantly decreased, compared with those by PFNA; however, no significant differences were observed in the aspects of tip–apex distance and pain at thigh or hip between these two groups. Conclusion Analysis of a large number of relevant clinical indicators available shows that InterTAN nail has better clinical manifestation than PFNA in treating unstable femoral intertrochanteric fractures.

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