• OBJECTIVES
    • To compare the radiological and clinical results with PFNA-II and InterTan in the treatment of unstable trochanteric fractures in the elderly.
  • DESIGN
    • Retrospective, multicenter, matched pair.
  • SETTING
    • Three tertiary level trauma centers.
  • PATIENTS
    • Hundred elderly patients who underwent intramedullary stabilization with either the PFNA-II or the InterTan for osteoporotic unstable trochanteric fractures.
  • INTERVENTIONS
    • Fifty matched pairs consisting of OTA/AO-A2 and A3 fractures were created from a cohort of 290 patients who underwent internal fixation for unstable trochanteric fractures with the PFNA-II or InterTan nails.
  • OUTCOME MEASUREMENTS
    • Radiological assessment was performed to compare union rates, varus collapse, medial or lateral screw/blade migration, and cut-out. Functional outcome at 1 year was assessed and compared using Harris hip score, Timed Up and Go test, and the mobility score.
  • RESULTS
    • Union rates, fracture reduction, neck shaft angle, and tip-apex distance were similar in both groups. The PFNA-II group had a significantly higher degree of lateral sliding of the helical blade (P < 0.001). The InterTan group had a better Harris hip score, mobility score, Timed Up and Go test scores, and abductor strength (P < 0.05) at 1 year. The incidence of varus collapse and medial blade migration were higher in the PFNA-II group (P > 0.05). The need for repeat surgery to address surgery-related complications were significantly high in the PFNA-II group (P = 0.045).
  • CONCLUSIONS
    • The InterTan may provide superior functional outcome and reduced complications than does the Proximal Femur Nail - Antirotation in elderly patients with unstable trochanteric fractures.
  • LEVEL OF EVIDENCE
    • Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.