International Journal of Research in Orthopaedics | November-December 2022 | Vol 8 | Issue 6 Page 686 International Journal of Research in Orthopaedics Kothiyal P et al. Int J Res Orthop. 2022 Nov;8(6):686-693 http://www.ijoro.org Original Research Article A comparative study of intertan nail versus proximal femoral nail antirotation in the treatment of peritrochanteric fractures Pranav Kothiyal*, Kunal Vij, Puneet Gupta, Shashank Sharma INTRODUCTION A trochanteric hip fracture occurs between the greater trochanter, where the gluteus medius and the gluteus minimus (hip extensors and abductors) attach, and the lesser trochanter, where the iliopsoas (hip flexor) attaches. 1,2 According to the epidemiologic projections, this worldwide annual number will rise to 6.26 million by the year 2050. This rise will be in great part due to the huge increase in the elderly population of the world. 3,4 As most patients are elderly treatment must be rapid to allow immediate postoperative weight bearing. 5 With evidences in support of intramedullary fixation, a large number of implants are available (e.g., gamma nail, InterTAN, PFNA). 6,7 PFNA (AO/ASIF) was developed especially for elderly patients to negate the Z effect complications as it has a single helical neck blade with a large surface area, for better purchase in osteoporotic bone. Helical blade avoids bone loss during drilling, permits antirotation, radial compaction of cancellous bone during insertion. 8 Increased stability caused by bone compaction around the PFNA blade has been biomechanically proven to retard rotation and varus collapse. Despite of all these mechanical advantages, few complications have been reported in few studies, ranging from lateral blade migration, lateral cortex splitting, shaft fracture, hip and thigh pain especially in Asian patients. 9,10 Concerned with these complications a newer nail PFNA II has been introduced with flat lateral shape and thereby reducing the chances of impingement of lateral proximal femoral cortex. 11 On the other hand ABSTRACT Background: Over the past decades the incidence of intertrochanteric fractures has increased and there is a universal agreement about the intramedullary nail being the preferred implant of fixation for these fractures. Methods: In this study we have attempted to assess and compare the results and immediate as well as long term outcome of fractures managed by proximal femoral nail anti rotation and the intertan nail. We included 102 patients in our study, half in the group managed by proximal femoral nail anti rotation group and half in the group managed by intertan nail. Over a period of almost one and half years we evaluated the patients in immediate and late post op period for the union of the fracture, functional outcomes and the short- and long-term complications. Results: The results were evaluated in the terms of intraoperative variables like fluoroscopy time, mean blood loss and reduction achieved and postoperatively in terms of superficial wound infections and Harris hip score and mobility score of paper and palmer which were comparable for both groups of patients with slight differences in some variables. Conclusions: We concluded that the intertan nail is a good option for fracture fixation in patients with unstable intertrochanteric fractures and though associated with a steeper learning curve it has lesser complications and slightly better functional outcomes as compared to the proximal femoral nail anti rotation. Keywords: PFNA2, Intertan, Peritrochanteric Department of Orthopaedics, Sri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India Received: 17 September 2022 Revised: 17 October 2022 Accepted: 19 October 2022 *Correspondence: Dr. Pranav Kothiyal, E-mail: kothiyalpranav@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: https://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20222708