Intertrochanteric Femoral Fractures: A Comparative Analysis of Clinical and Radiographic Outcomes Between Talon Intramedullary Nail and Intertan Nail

Abstract

Introduction Hip fractures in the elderly constitute a significant health concern, and their incidence is on the rise. It has been reported that intertrochanteric femoral fractures comprise a large portion of hip fractures, and they are especially prevalent among women. Over 75% of these types of fractures in the elderly occur as a result of simple falls. Surgical intervention must be performed for these fractures to expedite the healing process in patients. The application of a proximal femoral nail (PFN) is conducted using a minimally invasive technique after the fracture has been reduced using closed techniques. This technique maintains the fracture hematoma while minimizing the occurrence of consequences such as surgical trauma, hemorrhaging, infection, and issues with the wound site. This study aimed to assess the radiologic and functional outcomes among the groups following surgical procedures utilizing two distinct PFNs. Methods Between November 2021 and June 2023, a total of 96 individuals (38 males and 58 females) who underwent surgery for ITF using PFN were included in the study. Our surgical team utilized the Talon™ DistalFix™ PFN system (Orthopedic Designs North America Inc., FL, USA) and the Trigen InterTAN® nail (Smith & Nephew). Results The surgery time (number of scopes) for the Talon PFN was recorded as 25 (25-30), while it was 30 (30-35) in the InterTAN group (p<0.001). No nail protrusion was observed in the InterTAN group, whereas nail protrusion was observed in 12 patients (31.6%) in the Talon PFN group (p<0.001). Nail jamming was observed in two (5.3%) patients in the Talon PFN group, while none was observed in the InterTAN group (p<0.07). Conclusion In ITF fractures, the InterTAN nail is a more reliable implant. The shorter surgery time, reduced radiation exposure, and more minimally invasive nature of the Talon PFN might be preferred for geriatric patient populations with comorbidities where prolonged anesthesia could elevate mortality risks or for fractures of two or three pieces (Evans-Jansen Type 1 and Type 2). However, for more unstable fractures (Evans-Jensen Type 3) and in the active elderly patient group, we recommend the use of the InterTAN nail.