Comparision of PFN and INTERTAN nail for unstable intertrochanteric femoral fracture in mobile patients

Abstract

Objectives: The ideal implant for the treatment of an unstable intertrochanteric femoral fracture is still a matter of discussion. Intramedullary nails with different varieties of design offer good options in treatment. The aim of this study was to compare two intramedullary nails in different design and reveal the differences by evaluating radiological parameters of patients with unstable intertrochanteric femoral fracture in mobile patients. Material and Method: PFN and INTERTAN nails in two groups were compared overall in 63 patients. Reduction quality and the differences on varus collapse and neck shortening of femur by measuring radiological parameters on early and late postoperative X-rays were examined. Results: Similar radiological results were found between PFN and INTERTAN nails. Reduction quality of fractures was similar between groups. There was a significant difference only in the varus collapse degrees between groups (p<0,001) but no difference in neck shortening. The results revealed that INTERTAN has better resistance to occur varus collapse and the same prevention for neck shortening. Conclusion: Implant design is the one of major factors that may affect the results. INTERTAN nail made a difference in varus collapse of the neck but not in neck shortening. The results of this study have shown that the nail with two adjacent lag screws provides slightly better fixation properties preventing varus collapse than the nail with two separate lag screws. INTERTAN and PFN are currently good options in the treatment of unstable intertrochanteric femoral fractures and sustain enough stability during healing period in mobile patients.