ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1568584
Comparison of the efficacy of PFNA and InterTAN intramedullary nail in the treatment of unstable intertrochanteric femoral fractures in the elderly
Provisionally accepted
- Tianjin Third Central Hospital, Tianjin, China
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Purpose: To compare clinical outcomes between Proximal Femoral Nail Anti-rotation (PFNA) and InterTAN intramedullary nail system in treating unstable intertrochanteric femoral fractures (IFF) in elderly patients. Methods: A retrospective study of 381 patients with IFF at Tianjin Third Central Hospital compared PFNA (n=189) and InterTAN (n=192) surgical treatments. Patient demographics, surgical parameters, postoperative outcomes, Visual Analogue Scale (VAS) pain scores, and Harris hip scores were analyzed. Follow-up lasted 6-9 months through outpatient visits and telephone calls. Results: Both groups showed comparable baseline characteristics including age, gender, affected side, injury mechanism, comorbidities, and Tronzo-Evans classification (P>0.05). The PFNA group demonstrated clinically meaningful shorter operation times and reduced blood loss compared to InterTAN (P<0.05). The InterTAN group achieved earlier postoperative weight-bearing (P<0.05). No significant differences were found in hospitalization duration or intraoperative blood transfusion rates (P>0.05). Pain scores were lower in the InterTAN group during the early postoperative period (P<0.05). Harris hip scores were superior in the InterTAN group during the first week and month post-surgery (P<0.05), but showed no significant differences at three and six months (P>0.05). Postoperative complication rates were similar between groups (P>0.05). Conclusions: While both techniques demonstrated comparable long-term outcomes, PFNA may offer advantages in surgical efficiency and blood loss reduction, whereas InterTAN showed improved early postoperative outcomes regarding weight-bearing and initial pain management. The choice between techniques should consider patient-specific factors and surgical priorities. Further prospective studies are warranted to establish stronger clinical guidance.
Keywords: Intertrochanteric femoral fracture, PFNA, InterTAN, Aging, instability
Received: 30 Jan 2025; Accepted: 11 Jun 2025.
Copyright: © 2025 Feng, Li, Li, Chen and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shuzhang Guo, Tianjin Third Central Hospital, Tianjin, China
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