# Comparison of the efficacy of PFNA and InterTAN intramedullary nail in the treatment of unstable intertrochanteric femoral fractures in the elderly

## TL;DR

This study compares two surgical methods for treating hip fractures in elderly patients, finding each has unique advantages in operation time and recovery.

## Contribution

The study provides a direct comparison of PFNA and InterTAN for unstable intertrochanteric femoral fractures in the elderly.

## Key findings

- PFNA showed shorter operation times and less blood loss compared to InterTAN.
- InterTAN allowed earlier weight-bearing and better early pain management.
- Both techniques had similar long-term outcomes and complication rates.

## Abstract

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.

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 Analog Scale (VAS) pain scores, and Harris hip scores were analyzed. Follow-up lasted 6–9 months through outpatient visits and telephone calls.

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 3 and 6 months (P > 0.05). Postoperative complication rates were similar between groups (P > 0.05).

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.