title: Outcome of intertrochanteric fractures treated by intramedullary nail with two integrated lag screws: A study in Asian population.
abstract: BACKGROUND
  The incidence of intertrochanteric fracture has increased during recent years as life expectancy has also increased. Currently, orthopedic surgeons use various fixation methods for intertrochanteric fractures like, intramedullary (IM) nailing or dynamic hip screws and plates. The intramedullary (IM) nail with two integrated lag screws has been used recently in intertrochanteric fractures to overcome Z-affect phenomenon. However, no study is available in an Asian population. This prospective study was undertaken to document the clinical and radiologic outcomes of the IM nail with two integrated lag screws and its limitations in Asian patients.
  
  
  METHODS
  Osteosynthesis was performed using InterTAN nail in 100 patients with an intertrochanteric fractures followed up for at least 1 year after surgery. We evaluated the recovery rates to prefracture status, time to bony union and the incidence of complications.
  
  
  RESULTS
  Seventy four patients were available for at least 1 year followup examinations. Forty-five patients (60.8%) recovered prefracture status. Mean time to bony union was 18.3 ± 8.6 weeks. Intraoperative technical problems related to an unavoidable superior positioning of the lag screw occurred in five cases. Postoperative complications requiring reoperation occurred in three patients; two cases of varus collapse with cut out and one case of periprosthetic fracture.
  
  
  CONCLUSIONS
  The IM nail with two integrated lag screws showed favorable outcomes in Asian patients with an intertrochanteric fracture even though several complications that were not previously reported with this nail were found. The proper selection of patients and careful insertion of two lag screws should be mandatory in Asian patients.
authors.affiliation: Department of Orthopaedic Surgery, Gangnam Himchan Hospital, Seoul, South Korea.
authors.forename: Jong-Won
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Anyang, South Korea.
authors.forename: Tae-Young
authors.initials: TY
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Chung-Ang University, Seoul, South Korea.
authors.forename: Yong-Chan
authors.initials: YC
authors.lastname: Ha
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Young-Kyun
authors.initials: YK
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Kyung-Hoi
authors.initials: KH
authors.lastname: Koo
keywords: Hip; Hip fracture; fracture fixation; intertrochanteric fracture; intramedullary nail; intramedullary nailing; osteosynthesis fracture; proximal femur