Clinical application and effectiveness analysis of the InterTan nail in the treatment of femoral neck fractures

Objectives: To evaluate the clinical and radiographic outcomes of the InterTan nail as a stand-alone internal fixation device for predominantly high-energy displaced femoral neck fractures in younger and middle-aged adults. Methods: Design: Retrospective case series. Setting: Single-center study at a tertiary trauma hospital in China. Patient Selection Criteria: Patients aged ≤65 years with isolated, unilateral femoral neck fractures (OTA/AO 31B) treated with InterTan nail fixation between January 1, 2017, and January 1, 2022, were included. Patients with local infection or inflammation, open or pathological fractures, multiple fractures, severe systemic comorbidities precluding surgery, or psychiatric or neuromuscular disorders that could predispose to fixation failure or postoperative complications were excluded. Outcome Measures and Comparisons: Outcomes included reduction quality, fracture union, femoral neck shortening, complications, reoperation, Harris Hip Score, pain, and postoperative weight-bearing progression. Results: Twenty-five patients were included; mean age was 50.0 ± 13.2 years (range, 17–65 years), and 8 (32.0%) were female. Mean follow-up was 34.6 ± 17.6 months (range, 24–84 months). Twenty-one fractures (84.0%) were Pauwels type III and 21 (84.0%) were Garden type III or IV. All patients achieved acceptable reduction, defined as a Garden Alignment Index of 155°–180° on anteroposterior radiographs, and all fractures achieved union. Mean femoral neck shortening was 1.7 ± 1.9 mm (range, 0–7.3 mm). At 24 months, mean Harris Hip Score was 90.8 ± 6.2. One patient (4.0%) underwent reoperation for osteonecrosis of the femoral head within 2 years postoperatively. Conclusions: In patients aged ≤65 years with predominantly high-energy displaced femoral neck fractures, InterTan nail fixation following acceptable reduction was associated with fracture union in all patients, and a 4.0% reoperation rate within 2 years. These findings supported InterTan nail fixation as a potential fixation option for this specific patient population. Level of Evidence: Level IV