Clinical Outcome of Peritrochanteric Fractures Treatment with an Antegrade Trochanteric Static Lag Screw Nail (Inter TAN)

Abstract

Background: The preferred implant (intramedullary or extramedullary) of peritrochanteric fractures treatment is still on debate. The new cephalomedullary nail InterTAN permits intraoperative linear compression and prevents the excessive neck sliding, control shortening and  varus collapse of the neck, minimizing the risk of malunion or nonunion of the fracture. The aim of this study is to determine the clinical and functional outcomes of unstable peritrochanteric fractures treatment with the use of the InterTAN. Methods and Results: 126 consecutive unstable peritrochanteric fractures treated with an antegrade trochanteric nail InterTAN introduced to the study. The patients studied clinically and radiologically with the Harris Hip Score, Visual Analog Scale score and standard two view x-rays. Have been calculated intraoperatively and postoperatively at every follow up meeting the Tip Apex Index and the fracture Gap. The mean follow up was 19 months, mean age of the patient’s was 80.3 years and mean hospitalization time was 7.8 days. The mean Tip Apex Distance (TAD) immediately post-operatively was 22.34 mm. The mean fracture gap immediately post-operatively was 3 mm. The TAD and the fracture gap remain invariable until the last follow up. The modified- HHS was 85.7/91 at the last follow up (67-91) and the VAS 0.6 (0-10). Conclusion: The results of the new intertrochanteric antegrade nail InterTAN were satisfactory in most elderly patients. As a result of the negligible complication rate and improved clinical outcomes this implant is now the standard treatment for all unstable intertrochanteric fractures at our department.