InterTAN Intramedullary nail

Intertrochanteric hip fractures are common and devastating injuries especially for the elderly. Trochanteric fractures (TF) are the second most common fractures of the proximal femur after femoral neck fractures and are major sources of morbidity and mortality in today’s ageing population.

By 2050, the annual number of hip fractures worldwide is estimated to surpass 6.3 million due to an ageing demographic in many Western countries. In the USA alone, the number of hip fractures is estimated to increase from about 320,000 per year to 580,000 by 2040. This increasing demand creates significant tension for the health service in terms of staff and resources required to manage these patients. In the USA, healthcare costs for the management of hip fractures are estimated to exceed $10 billion per year, whilst the impact on the UK health service is estimated to be $2 billion per year. These costs are driven not only by the costs of the acute surgical procedure but also the post-acute care, including rehabilitation. Whilst hip fracture surgery is highly effective, patients are likely to experience significant morbidity in terms of pain, discomfort and limited mobility during their recovery and in many cases are unlikely to achieve pre-fracture levels of function. Studies also suggest that there is an association between hip fracture and increased rates of mortality with 30% more deaths observed than the age-matched populations with and without hip fracture. However, some caution should be taken in interpreting such data, as individuals who experience a hip fracture may be inherently more fragile and susceptible to ill-health.

Worldwide, the incidence of fractures of the proximal femur is increasing because of a demographic transition resulting in higher life expectancy.

Surgical treatment is the optimal strategy for managing intertrochanteric fractures as it allows early rehabilitation and functional recovery.

To reduce the complications of prolonged immobilization, timely operative interventions providing sound stabilization of the fracture and early mobilization of the patients have become the preferred solution for the treatment of these fractures. Once dynamic hip screw (DHS) internal fixation is one of the most primary options, but it performs less well with a relatively higher incidence of internal fixation failure for unstable TF. In addition, this surgical procedure may result in substantial blood loss, soft tissue damage, and worsening of existing comorbidities in elderly patients. Therefore, intramedullary fixation devices have become more popular due to biomechanical advantages in the treatment of unstable TF compared with DHS internal fixation.

The Intertan Nail using 2 cephalocervical screws in an integrated mechanism, shows increasing stability and resistance to intraoperative and postoperative femoral head rotation compared with the traditional intramedullary nailing system. A biomechanical study showed that the Intertan Nail possesses more biomechanical benefits for internal fixation of unstable fractures compared with the traditional intramedullary nailing system Intertan Nail. Some studies reported that the surgical procedure had a good clinical outcome and a low number of complications]. The biomechanical study of Nüchtern et al. showed that Intertan Nail achieves more stability with a higher tip apex distance and withstand the higher loads.