Comparison of clinical outcomes with three different intramedullary nailing devices in the treatment of unstable trochanteric fractures

Abstract

BACKGROUND: The aim of this study was toreport our experience regarding the use of three different methods for intramedullary nailing in the treatment of intertrochanteric fractures. METHODS: Patients with A2 and A3 type fractures operated on for unstable trochanteric fractures were included into this retrospective cohort study. Patients were divided into three groups based on the technique used; Talon distal fix nail/lag screw (n=78; mean age, 78.5±6.6), PFNA nail (n=96; mean age, 77.2±6.8) or InterTan nails (n=102; mean age, 76.8±6.7). Harris hip scores were recorded at the last outpatient visit and survival information was obtained by phone interview and civil registry database. RESULTS: Baseline characteristics were similar among groups. Operation time, fluoroscopy time and blood loss were significantly higher in InterTan group. Screw cut-out occurred in eight patients in PFNA group. In-hospital mortality occurred in nine (3.2%) patients. Length of hospital stay and postoperative tip-apex distance was not different among groups. At follow-up, healing time and Harris hip scores were also similar among groups. One-year survival rate was 83.1±4.5% in Talon distal fix nail/lag screw, 84.0±3.8% in PFNA group and 84.4±3.7% in InterTan group (p=0.33). CONCLUSION: New Talon distal fix nail/lag screw was associated with lower cut-out rates than PFNA and shorter operative times than InterTan. Further study is warranted to clearly establish the potential advantages of Talon distal fix over any other technique described herein.