{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:04:36Z","timestamp":1793138676163,"version":"4.5.0"},"reference-count":41,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T00:00:00Z","timestamp":1678665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The aim of this study was to evaluate retrospectively the radiological and functional outcomes of closed reduction and internal fixation for intertrochanteric femoral fractures (IFF) using three different proximal femoral nails (PFN). Materials and Methods: In total, 309 individuals (143 males and 166 females) who underwent surgery for IFF using a PFN between January 2018 and January 2021 were included in the study. Our surgical team conducted osteosynthesis using the A-PFN\u00ae (TST, Istanbul, Turkey) nail, the PROFIN\u00ae (TST, Istanbul, Turkey), and the Trigen InterTAN (Smith &amp; Nephew, Memphis, TN, USA) nail. The PFNs were compared based on age, gender, body mass index (BMI), length of stay (LOS) in intensive care, whether to be admitted to intensive care, mortality in the first year, amount of transfusion, preoperative time to surgery, hospitalisation time, duration of surgery and fluoroscopy, fracture type and reduction quality, complication ratio, and clinical and radiological outcomes. The patients\u2019 function was measured with the Harris Hip Score (HHS) and the Katz Index of Independence in Activities of Daily Living (ADL). Results: Pain in the hip and thigh is the most common complication, followed by the V-effect. The Z-effect was seen in 5.7% of PROFIN patients. A-PFN was shown to have longer surgical and fluoroscopy durations, lower HHS values, and much lower Katz ADL Index values compared to the other two PFNs. The V-effect occurrence was significantly higher in the A-PFN group (36.7%) than in the InterTAN group. The V-effect was seen in 33.1% of 31A2-type fractures but in none of the 31A3-type fractures. Conclusions: InterTAN nails are the best choice for IFFs because they have high clinical scores after surgery, there is no chance of Z-effect, and the rate of V-effect is low.<\/jats:p>","DOI":"10.3390\/medicina59030559","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T06:09:56Z","timestamp":1678687796000},"page":"559","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Intertrochanteric Femoral Fractures: A Comparison of Clinical and Radiographic Results with the Proximal Femoral Intramedullary Nail (PROFIN), the Anti-Rotation Proximal Femoral Nail (A-PFN), and the InterTAN Nail"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8281-9885","authenticated-orcid":false,"given":"Mustafa","family":"Yal\u0131n","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology, Fethi Sekin City Hospital, Elaz\u0131\u011f 23280, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1715-3471","authenticated-orcid":false,"given":"Fatih","family":"Golgelioglu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Fethi Sekin City Hospital, Elaz\u0131\u011f 23280, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3620-936X","authenticated-orcid":false,"given":"Sefa","family":"Key","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Faculty of Medicine, Firat University, Elaz\u0131\u011f 23190, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"9607","DOI":"10.1038\/s41598-020-66614-5","article-title":"Risk factors and mortality of patients undergoing hip fracture surgery: A one-year follow-up study","volume":"10","author":"Huette","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s11657-013-0137-0","article-title":"Osteoporosis in the European Union: A compendium of country-specific reports","volume":"8","author":"Svedbom","year":"2013","journal-title":"Arch. Osteoporos."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s40001-021-00556-0","article-title":"Management of proximal femur fractures in the elderly: Current concepts and treatment options","volume":"26","author":"Fischer","year":"2021","journal-title":"Eur. J. Med. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"212","DOI":"10.4103\/0019-5413.40260","article-title":"Role of gamma nail in management of pertrochanteric fractures of femur","volume":"42","author":"Sharma","year":"2008","journal-title":"Indian J. Orthop."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1628","DOI":"10.12659\/MSM.890962","article-title":"Proximal femoral nail vs. dynamic hip screw in treatment of intertrochanteric fractures: A meta-analysis","volume":"20","author":"Zhang","year":"2014","journal-title":"Med. Sci. Monit."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2151459319859139","DOI":"10.1177\/2151459319859139","article-title":"Hip Fractures: Relevant Anatomy, Classification, and Biomechanics of Fracture and Fixation","volume":"10","author":"Lu","year":"2019","journal-title":"Geriatr. Orthop. Surg. Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.injury.2016.12.014","article-title":"Removal of a broken trigen intertan intertrochanteric antegrade nail","volume":"48","author":"Zheng","year":"2017","journal-title":"Injury"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.aott.2018.02.009","article-title":"Intramedullary versus extramedullary internal fixation for unstable intertrochanteric fracture, a meta-analysis","volume":"52","author":"Yu","year":"2018","journal-title":"Acta Orthop. Traumatol. Turc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1007\/s00264-016-3308-y","article-title":"Intramedullary and extramedullary fixations for the treatment of unstable femoral intertrochanteric fractures: A meta-analysis of prospective randomized controlled trials","volume":"41","author":"Li","year":"2017","journal-title":"Int. Orthop."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/j.injury.2008.10.014","article-title":"The AO\/ASIF proximal femoral nail antirotation (PFNA): A new design for the treatment of unstable proximal femoral fractures","volume":"40","author":"Mereddy","year":"2009","journal-title":"Injury"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s13018-018-0749-6","article-title":"Comparison of a twin interlocking derotation and compression screw cephalomedullary nail (InterTAN) with a single screw derotation cephalomedullary nail (proximal femoral nail antirotation): A systematic review and meta-analysis for intertrochanteric fractures","volume":"13","author":"Nherera","year":"2018","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_12","first-page":"385","article-title":"Comparison of two types of proximal femoral hails in the treatment of intertrochanteric femur fractures","volume":"21","author":"Uzer","year":"2015","journal-title":"Ulus. Travma Acil Cerrahi Derg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"7","DOI":"10.5152\/eurasianjmed.2017.15289","article-title":"Comparison of Second and Third-Generation Nails in the Treatment of Intertrochanteric Fracture: Screws versus Helical Blades","volume":"49","author":"Kumbaraci","year":"2017","journal-title":"Eurasian J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.1007\/s00264-011-1232-8","article-title":"Prospective randomised study comparing screw versus helical blade in the treatment of low-energy trochanteric fractures","volume":"35","author":"Stern","year":"2011","journal-title":"Int. Orthop."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.1007\/s00264-012-1684-5","article-title":"Intertrochanteric fractures: Comparison between two different locking nails","volume":"36","author":"Carcangiu","year":"2012","journal-title":"Int. Orthop."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1001\/jama.1963.03060120024016","article-title":"Studies of Illness in the Aged. The Index of ADL: A Standardized Measure of Biological and Psychosocial Function","volume":"185","author":"Katz","year":"1963","journal-title":"JAMA"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.jclinepi.2006.02.022","article-title":"Katz\u2019 ADL index assessed functional performance of Turkish, Moroccan, and Dutch elderly","volume":"60","author":"Reijneveld","year":"2007","journal-title":"J. Clin. Epidemiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s00402-003-0586-9","article-title":"Intramedullary fixation of pertrochanteric hip fractures with the short AO-ASIF proximal femoral nail","volume":"124","author":"Fogagnolo","year":"2004","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1186\/s13018-018-0911-1","article-title":"The relationship between the type of unstable intertrochanteric femur fracture and mobility in the elderly","volume":"13","author":"Karakus","year":"2018","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2022","DOI":"10.1016\/j.injury.2019.07.022","article-title":"Effectiveness of distally slotted proximal femoral nails on prevention of femur fractures during and after intertrochanteric femur fracture surgery","volume":"50","author":"Soylemez","year":"2019","journal-title":"Injury"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"643","DOI":"10.2106\/00004623-200105000-00001","article-title":"Reverse obliquity fractures of the intertrochanteric region of the femur","volume":"83","author":"Haidukewych","year":"2001","journal-title":"J. Bone Joint Surg. Am."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Liu, P., Jin, D., Zhang, C., and Gao, Y. (2020). Revision surgery due to failed internal fixation of intertrochanteric femoral fracture: Current state-of-the-art. BMC Musculoskelet. Disord., 21.","DOI":"10.1186\/s12891-020-03593-8"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"131","DOI":"10.5435\/JAAOS-D-14-00432","article-title":"Management of hip fractures in the elderly","volume":"23","author":"Roberts","year":"2015","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1097\/BOT.0000000000000284","article-title":"What makes an intertrochanteric fracture unstable in 2015? Does the lateral wall play a role in the decision matrix?","volume":"29","author":"Tawari","year":"2015","journal-title":"J. Orthop. Trauma"},{"key":"ref_25","first-page":"792","article-title":"The unstable intertrochanteric hip fracture","volume":"31","author":"Lichtblau","year":"2008","journal-title":"Orthopedics"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1016\/j.injury.2010.03.005","article-title":"Comparative study of trochanteric fracture treated with the proximal femoral nail anti-rotation and the third generation of gamma nail","volume":"41","author":"Yaozeng","year":"2010","journal-title":"Injury"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/j.injury.2022.02.002","article-title":"Stabilisation of AO OTA 31-A unstable proximal femoral fractures: Does the choice of intramedullary nail affect the incidence of post-operative complications? A systematic literature review and meta-analysis","volume":"53","author":"Quartley","year":"2022","journal-title":"Injury"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1007\/s00590-019-02454-y","article-title":"The impact of proximal femoral nail type on clinical and radiological outcomes in the treatment of intertrochanteric femur fractures: A comparative study","volume":"29","author":"Duramaz","year":"2019","journal-title":"Eur. J. Orthop. Surg. Traumatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"107","DOI":"10.3944\/AOTT.2012.2501","article-title":"Intramedullary osteosynthesis of instable intertrochanteric femur fractures with Profin\u00ae nail in elderly patients","volume":"46","author":"Kara","year":"2012","journal-title":"Acta Orthop. Traumatol. Turc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1097\/BOT.0b013e31819211b2","article-title":"The treatment of intertrochanteric fractures: Results using an intramedullary nail with integrated cephalocervical screws and linear compression","volume":"23","author":"Ruecker","year":"2009","journal-title":"J. Orthop. Trauma"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1007\/s00264-013-2120-1","article-title":"A comparative biomechanical study of proximal femoral nail (InterTAN) and proximal femoral nail antirotation for intertrochanteric fractures","volume":"37","author":"Huang","year":"2013","journal-title":"Int. Orthop."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Lin, P.H., Chien, J.T., Hung, J.P., Hong, C.K., Tsai, T.Y., and Yang, C.C. (2020). Unstable intertrochanteric fractures are associated with a greater hemoglobin drop during the perioperative period: A retrospective case control study. BMC Musculoskelet. Disord., 21.","DOI":"10.1186\/s12891-020-03208-2"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1097\/BOT.0000000000001145","article-title":"Helical Blade or the Integrated Lag Screws: A Matched Pair Analysis of 100 Patients With Unstable Trochanteric Fractures","volume":"32","author":"Gavaskar","year":"2018","journal-title":"J. Orthop. Trauma"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s13018-016-0344-7","article-title":"A retrospective analysis of the InterTan nail and proximal femoral nail anti-rotation-Asia in the treatment of unstable intertrochanteric femur fractures in the elderly","volume":"11","author":"Yu","year":"2016","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_35","first-page":"469","article-title":"Comparison of clinical outcomes with three different intramedullary nailing devices in the treatment of unstable trochanteric fractures","volume":"21","author":"Zehir","year":"2015","journal-title":"Ulus. Travma Acil Cerrahi Derg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"271","DOI":"10.14235\/bas.galenos.2018.2798","article-title":"Comparison of Third Generation Proximal Femoral Nails in Treatment of Reverse Oblique Intertrochanteric Fractures","volume":"7","author":"Tekin","year":"2019","journal-title":"Bezmialem Sci."},{"key":"ref_37","first-page":"123","article-title":"A comparison of the InterTan nail and proximal femoral fail antirotation in the treatment of reverse intertrochanteric femoral fractures","volume":"84","author":"Aydogan","year":"2018","journal-title":"Acta Orthop. Belg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1177\/0300060518761504","article-title":"Optimizing stability in AO\/OTA 31-A2 intertrochanteric fracture fixation in older patients with osteoporosis","volume":"46","author":"Zhang","year":"2018","journal-title":"J. Int. Med. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"3000605211003766","DOI":"10.1177\/03000605211003766","article-title":"Benefit of lag screw placement by a single- or two-screw nailing system in elderly patients with AO\/OTA 31-A2 trochanteric fractures","volume":"49","author":"Zhao","year":"2021","journal-title":"J. Int. Med. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1111\/os.12038","article-title":"Surgical treatment of basicervical intertrochanteric fractures of the proximal femur with cephalomeduallary hip nails","volume":"5","author":"Hu","year":"2013","journal-title":"Orthop. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"102863","DOI":"10.1016\/j.otsr.2021.102863","article-title":"The V-effect in fixation of intertrochanteric fractures with proximal femoral nails","volume":"107","author":"Eceviz","year":"2021","journal-title":"Orthop. Traumatol. Surg. Res."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/3\/559\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:53:41Z","timestamp":1760122421000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/3\/559"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,13]]},"references-count":41,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["medicina59030559"],"URL":"https:\/\/doi.org\/10.3390\/medicina59030559","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,13]]}}}