{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T22:49:20Z","timestamp":1779230960588,"version":"3.51.4"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T00:00:00Z","timestamp":1695859200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The intramedullary nail is considered the gold standard for treating AO\/OTA type A3.3 intertrochanteric fractures. However, it still faces a significant rate of failure, mainly due to the critical factor of comminuted lateral wall defects leading to inadequate proximal sliding compression. The primary objective of this study is to investigate the requirement of sliding compression in the treatment of unstable AO\/OTA type A3.3 intertrochanteric fractures. To achieve this, we conduct a comparative analysis between two approaches: InterTAN alone and proximal femoral anti\u2010rotation blade nailing (PFNA) combined with lateral wall reconstruction for treating AO\/OTA type A3.3 intertrochanteric fractures with lateral wall damage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was conducted on the clinical data of patients who underwent intramedullary nailing fixation for AO\/OTA type A3.3 intertrochanteric fractures at our hospital from January 2012 to January 2022. Patient characteristics as well as treatment details, including operative time, intraoperative blood loss, weight\u2010bearing time, fracture healing time, tip apex distance (TAD) loss, Harris hip scores (HHS), Parker\u2013Palmer mobility score (PPMS), and postoperative complications, were collected and analyzed. Continuous variables were analyzed using independent sample <jats:italic>t<\/jats:italic>\u2010tests, while categorical variables were examined using the chi\u2010square test. For group comparisons, variance analysis was applied, and pairwise comparisons were conducted using the LSD\u2010<jats:italic>t<\/jats:italic> test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>These patients were divided into PFNA combined with lateral wall reconstruction group (sliding compression group) and InterTAN fixation group (static fixation group) based on surgical methods. The operation time, intraoperative bleeding loss, HHS at 12\u2009months and PPMS at 12\u2009months in the sliding compression group were significantly higher than those in the static fixation group, and time to weight\u2010bearing and fracture healing time were significantly lower than those in the static fixation group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). There were no significant differences between two groups in terms of the TAD at 2\u2009days, 2, and 12\u2009months postoperatively, the incidence of complications (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). At 6\u2009months postoperatively, femoral neck length was shortened compared to 2\u2009days postoperatively in both groups, and the sliding compression group had a significantly greater degree of femoral neck shortening than the static fixation group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of PFNA with lateral wall reconstruction for A3.3 intertrochanteric fractures demonstrated superior mobility, efficiency, and reduced internal fixation failure rates compared to InterTAN. These findings suggest that sliding compression may be required for intramedullary nailing treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13875","type":"journal-article","created":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T08:04:07Z","timestamp":1695888247000},"page":"2805-2813","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Is Sliding Compression Necessary for Intramedullary Nailing Fixation of <scp>AO<\/scp>\/<scp>OTA<\/scp> Type A3.3 Intertrochanteric Fracture?"],"prefix":"10.1111","volume":"15","author":[{"given":"Cong","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Orthopedics The 909th Hospital, School of Medicine, Xiamen University  Zhangzhou China"},{"name":"School of Medicine Xiamen University  Xiamen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3416-7637","authenticated-orcid":false,"given":"Zhangxin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The 909th Hospital, School of Medicine, Xiamen University  Zhangzhou China"},{"name":"School of Medicine Xiamen University  Xiamen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengyuan","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Medicine Xiamen University  Xiamen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiyu","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Medicine Xiamen University  Xiamen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingqi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The 909th Hospital, School of Medicine, Xiamen University  Zhangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenqing","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The 909th Hospital, School of Medicine, Xiamen University  Zhangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenqi","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The 909th Hospital, School of Medicine, Xiamen University  Zhangzhou China"},{"name":"School of Medicine Xiamen University  Xiamen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guofeng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The 909th Hospital, School of Medicine, Xiamen University  Zhangzhou China"},{"name":"School of Medicine Xiamen University  Xiamen China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,28]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200711101-00001"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-019-01251-w"},{"key":"e_1_2_13_4_1","first-page":"21","article-title":"Comparison of outcome of management of unstable pertrochanteric femoral fractures with dynamic hip screw and proximal femoral nail. 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