. INTERTAN ~ Tronzo Evans [3] 2971 Singh [4] 339( )2Colles INTERTAN () Evans Singh Harris ()

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1 Journal of Clinical Rehabilitative Tissue Engineering Research June 25, 2009 Vol.13, No.26 INTERTAN19 Features of intramedullary nail INTERTAN for intertrochanteric fractures: Retrospective analysis of 19 cases Lü Gang, Chen Ping-bo, Lü Fa-ming Department of Orthopaedic Surgery, Chinese Medical Hospital of Xinjiang Medical University, Urumchi , Xinjiang Uygur Autonomous Region, China Lü Gang, Master, Attending physician, Department of Orthopaedic Surgery, Chinese Medical Hospital of Xinjiang Medical University, Urumchi , Xinjiang Uygur Autonomous Region, China Received: Accepted: Abstract: The 19 consecutive patients with falling-caused intertrochanteric fracture were admitted to Department of Orthopaedic Surgery, Chinese Medical Hospital of Xinjiang Medical University in July 2008, including 10 males and 9 females, aged 74.5 years (ranging 6786 years), 11 with right and 8 with left. According to Tronzo and Evans classification, there were 2 cases of type, 9 of type, 7 of type, and 1 of type. Nine patients were of grade 3 or below according to Singh grading (obvious osteoporosis). All patients were treated with INTERTAN. The internal fixation time, Harris hip score, fracture healing and perioperative complications were recorded. All 19 patients were followed up for 6.2 months (ranging 58 months). The average surgical time was 65 minutes (ranging minutes). A total of 13 patients restored to their prefracture level. The Harris score at the final follow up was 77.6 scores (ranging 30-92), including 5 cases of excellent, 9 of good, 3 of fair, 2 of poor with the good and excellent rate of 74%. The pain in 95% of the patients was relieved over a short period of time after surgery. All fractures healed on the radiographs within the average of 2.6 months (ranging 24 months). There was one collapse of the neck, no varus malposition, femoral shaft fracture, or implant failures were found. The new intertrochanteric antegrade nail of INTERTAN can be used to treat various femoral intertrochanteric fractures with good clinical outcomes, high union rate, and rare complications. Lü G, Chen PB, Lü FM. Features of intramedullary nail INTERTAN for intertrochanteric fractures: Retrospective analysis of 19 cases.zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu. 2009;13(26): [ ~ Tronzo Evans Singh () INTERTAN Harris 19 5~ ~126 min 65 min13 Harris 30~ % 95% 19 2~ INTERTAN INTERTAN doi: /j.issn INTERTAN 19 [J] (26): [ lvgangxj@163. com :R318 :B : (2009) ( /WL A) 0 3 [1] DHSGamma PFN SmithNephew TRIGEN( )INTERTAN() Ruecker [2] JOURNAL OF ORTHOPAEDIC TRAUMA INTERTAN Smith&Nephew() INTERTAN

2 . INTERTAN ~ Tronzo Evans [3] 2971 Singh [4] 339( )2Colles INTERTAN () Evans Singh Harris () INTERTAN INTERTAN INTERTAN INTERTAN INTERTAN INTERTAN INTERTAN INTERTAN INTERTAN INTERTAN INTERTAN Colles INTERTAN INTERTAN INTERTAN INTERTAN INTERTAN INTERTAN INTERTAN INTERTAN INTERTAN 4 Z 1~3 Figure 2 Lateral Intertan nail with trapezoidal shape of proximal nail and a single lag screw device placed in the femoral head 2 Intertan Figure 1 Model of Intertan implanted in bone 1 Intertan Figure 3 Integrated screws showing track on larger lag screw that permits nesting to allow lower screw to provide linear compression 3 ISSN CN /R CODEN: ZLKHAH 5163

3 INTERTAN d3.7 d ~40 C 6~8 cm (TAD 25 mm) 9 13 () 24 h 3 d 2 ()2 24 h X 4 10( )10 mm HarrisHarris 10090~10080~8970~ < 70 SPSS 11.0 t P < INTERTAN 45~126 min65 min 120~440 ml287 ml200~600 ml 330 ml15~30 d19.7 d ~ Harris53~ Harris30~ % % 2~28 d8.1 d 1~83.3 (Singh33) (9.0±3.8) d(5.6±2.4) d (P < 0.05) ~42.61 > 10 mm 4~6 a: X-ray b: CT Figure 4 Preoperative imaging of case 1, male, 78 years old, with falling-caused fracture 4 178

4 . INTERTAN 19 a: Anteroposterior b: Frog leg Figure 5 Imaging of 24 hours after proximal Intertan nail fixation 5 InterTan 24 h a: Anteroposterior b: Frog leg Figure 6 Imaging of 2 months after proximal Intertan nail fixation 6 InterTan 2 (min) (ml) (d) (d) Harris () () (DHS) [5-8] 6%~19%56% [9-10] (Gamma) GammaDHS [ ] DHS 2 2 (TAD) [13] PFN DHS [14-15] PFN [16] INTERTAN 15 mm ISSN CN /R CODEN: ZLKHAH 5165

5 INTERTAN 19 Z [17] Z 74% 95% [18-19] INTERTAN 4 [1] Huang JF, Deng YZ, Wan LY. Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu. 2006;10(40): ,,.[J].,2006,10(40): [2] Ruecker AH, Rupprecht M, Gruber M, et al. The treatment of intertrochanteric fractures: results using an intramedullary nail with integrated cephalocervical screws and linear compression. J Orthop Trauma. 2009;23(1): [3] S.Terry Canale. CANPBELL S Operative Orthopaedics. Elsecier(Singapore) Pet Ltd. 2005;52: [4] Wang YC. Beijing: People s Medical Publishing House. 2004: [M].:,2004: [5] Ahrengart L, Törnkvist H, Fornander P, et al. A randomized study of the compression hip screw and Gamma nail in 426 fractures. Clin Orthop Relat Res. 2002;(401): [6] Schipper IB, Marti RK, van der Werken C. Unstable trochanteric femoral fractures: extramedullary or intramedullary fixation. Review of literature. Injury. 2004;35(2): [7] Hardy DC, Descamps PY, Krallis P, et al. Use of an intramedullary hip-screw compared with a compression hip-screw with a plate for intertrochanteric femoral fractures. A prospective, randomized study of one hundred patients. J Bone Joint Surg Am. 1998; 80(5): [8] Madsen JE, Naess L, Aune AK, et al. Dynamic hip screw with trochanteric stabilizing plate in the treatment of unstable proximal femoral fractures: a comparative study with the Gamma nail and compression hip screw. J Orthop Trauma. 1998;12(4): [9] Lunsjö K, Ceder L, Tidermark J, et al. Extramedullary fixation of 107 subtrochanteric fractures: a randomized multicenter trial of the Medoff sliding plate versus 3 other screw-plate systems. Acta Orthop Scand. 1999;70(5): [10] Haidukewych GJ, Israel TA, Berry DJ. Reverse obliquity fractures of the intertrochanteric region of the femur. J Bone Joint Surg Am. 2001;83-A(5): [11] Saudan M, Lübbeke A, Sadowski C, et al. Pertrochanteric fractures: is there an advantage to an intramedullary nail?: a randomized, prospective study of 206 patients comparing the dynamic hip screw and proximal femoral nail. J Orthop Trauma. 2002;16(6): [12] Haidukewych GJ, Berry DJ. Salvage of failed internal fixation of intertrochanteric hip fractures. Clin Orthop Relat Res. 2003;(412): [13] Baumgaertner MR, Curtin SL, Lindskog DM, et al. The value of the tip-apex distance in predicting failure of fixation of peritrochanteric fractures of the hip. J Bone Joint Surg Am. 1995; 77(7): [14] Docquier PL, Manche E, Autrique JC, et al. Complications associated with gamma nailing. A review of 439 cases. Acta Orthop Belg. 2002;68(3): [15] Utrilla AL, Reig JS, Muñoz FM, et al. Trochanteric gamma nail and compression hip screw for trochanteric fractures: a randomized, prospective, comparative study in 210 elderly patients with a new design of the gamma nail. J Orthop Trauma. 2005;19(4): [16] Megas P, Kaisidis A, Zouboulis P, et al. Comparative study of the treatment of pertrochanteric fractures--trochanteric gamma nail vs. proximal femoral nail. Z Orthop Ihre Grenzgeb. 2005;143(2): [17] Werner-Tutschku W, Lajtai G, Schmiedhuber G, et al. Intra- and perioperative complications in the stabilization of per- and subtrochanteric femoral fractures by means of PFN. Unfallchirurg. 2002;105(10): [18] Webb LX. Proximal femoral fractures. J South Orthop Assoc. 2002;11(4): [19] Lin WC, Chen CH, Wong CY. Salvage procedures for failed compression hip screw fixation of intertrochanteric femoral fractures: analysis of 50 cases. Kaohsiung J Med Sci. 2002;18(9): Intertan Intertan ( ) Intertan 5166

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