Functional and Radiological Outcome of PFN vs. InterTAN in Fixation of Unstable Intertrochanteric Fracture  

Abstract

Background and Objectives: Intertrochanteric fractures of the femur are common in the elderly and are associated with considerable morbidity. The usual treatment is an intramedullary fixation with cephalomedullary nails. However, the comparative effectiveness of InterTAN and the proximal femoral nail (PFN) remain controversial. The aim of this study was to compare clinical, radiological, and functional results between InterTAN and PFN fixation of unstable intertrochanteric fractures of the femur.  Methods: A prospective study was carried out from February 2024 to September 2025 and included 101 patients with unstable intertrochanteric femur fractures (AO/OTA 31-A2 and 31-A3). Of these, 45 had an InterTAN fixation, and 56 had a PFN. Data were recorded on demographics, operative details, complications, and radiological results; functional recovery was evaluated using the Harris hip score (HHS) and visual analog scale (VAS) at 6, 12, and 24 weeks. Data were analyzed statistically using SPSS version 25. Significance was defined as p ≤ 0.05. Results: There were no significant differences between the groups (p > 0.05) in baseline characteristics. Operative time and blood loss were slightly lower in the PFN group, but these differences were not significant (p = 0.28). The InterTAN group had better alignment and fewer mechanical complications (1.8% vs 11.1%), but this did not reach statistical significance (p = 0.15). Union rate and functional recovery were similar, with 86.7% of InterTAN and 91.1% of PFN achieving HHS ≥ 80 at 24 weeks (p= 0.87). There were no significant differences in infection rate, hospital stay or complications.  Conclusion: Both implants provide reliable fixation and comparable functional results; however, InterTAN provides better fracture alignment and PFN shorter operative times, although these individual trends were not statistically significant.