Overview of Intertan Femoral Nail in Modern Orthopedics
If you talk to surgeons who deal with hip fractures on a regular basis, most will admit that these injuries can test both patience and skill. The hip, especially the proximal part of the femur, is a tricky region. Elderly patients often come in after a fall at home, while younger patients might land in the trauma bay after a high-speed accident. In both groups, stability is crucial.
Over the years, intramedullary nails have been refined again and again. Some solved problems, others created new ones. The Intertan femoral nail came in as a genuine step forward, not just a cosmetic upgrade. The idea of locking two screws together inside the head of the femur immediately addressed one of the biggest frustrations with single-screw systems—rotational instability and eventual cut-out. It sounds simple, but in practice, it changes the whole experience of fixation.
Key Features Worth Highlighting
The design works because the details were thought through:
- Twin lag screws working together, not fighting each other. That alone reduces screw migration.
- Built-in compression, which the surgeon can control during the procedure, nudges fracture fragments into contact instead of leaving gaps.
- The fit of the proximal part of the nail is anatomically sympathetic. Anyone who has watched an older, stiff PFN insertion knows how much difference this makes.
- Distal locking versatility is valuable. Sometimes you need rigid stability, other times controlled dynamism. This nail allows both.
- And finally, the reduced cut-out risk is not just theory—it’s a pattern confirmed across large clinical series.
Surgical Technique
Textbook steps exist—and we read them all—but the lived version looks something like this:
- Pre-op preparation usually starts with checking X-rays and sometimes CT scans. It’s not about just picking “a nail,” but choosing length, diameter, and screw size appropriately.
- Positioning on the fracture table, with traction. Often, this step takes longer than textbooks admit, especially with unstable fracture lines.
- Entry point at the greater trochanter—sounds easy, but surgeons will tell you an off-center start makes the whole procedure messy.
- Guidewire placement under fluoroscopy. Everyone holds their breath for a second until it looks straight.
- Reaming and nail insertion follow, though many cases don’t need aggressive reaming.
- Twin-screw fixation in the femoral head—this is the hallmark. Compression follows, and if done gently, it actually helps bone healing visibly on follow-ups.
- Distal locking may frustrate juniors at times under fluoroscopy, but angle and patience sort it out.
- Closure and recovery—and in better cases, walking initiation can start remarkably early if fixation is solid.
Indications in Everyday Practice
The Intertan nail does not fit every story, but in daily trauma practice, there are places where it shines:
- Standard intertrochanteric fractures—where traditional DHS or PFN could do the job, but Intertan often does it more securely.
- Unstable intertrochanteric patterns, where rotational control really matters.
- Subtrochanteric fractures, particularly the comminuted messier ones where stability is everything.
- Osteoporotic hips, very common in the elderly, where bone doesn’t hold up to traditional screws.
- Cases where previous fixation failed, giving surgeons fewer second chances.
Biomechanical Edge Over Conventional Nails
The biomechanical difference isn’t hard to summarize. With single screws, rotational instability and varus collapse were constant companions. With the Intertan system:
- The rotation is resisted naturally by the locked twin screws.
- Compression can be applied—which isn’t always the case in older nails.
- Forces are shared, not concentrated, which explains the lower incidence of screw migration.
- Collapse in varus is noticeably less frequent.
- And the surgery tends to move quicker once the entry and guidewire are on point, because the system feels predictable.
Biomechanical testing in laboratories confirmed these edges, but more importantly, clinical follow-up kept confirming the same patterns.
Real-World Clinical Outcomes
Several independent studies, both small case series and larger systematic reviews, converge on similar findings:
- Healing rates consistently above 95%.
- Complication rates lower compared to older intramedullary or extramedullary devices.
- Reduced re-operations, which matters to both hospitals and patients.
- Functional scores (Harris Hip Score, mobility indexes) are modestly but consistently better.
What often catches attention is early mobilization in elderly patients. Being able to sit, stand, and walk sooner shortens hospital stay, prevents bed-related complications, and significantly improves patient morale. That’s something clinicians notice even outside the controlled environment of published studies.
Challenges Surgeons Still Talk About
No technique is perfect. Surgeons who use Intertan regularly will tell you about some pitfalls:
- Missed entry point ruins alignment and throws everything off.
- Lag screw placement matters—ignore the tip-apex distance rule at your peril.
- Compression is wonderful, but too much can strangle femoral head circulation.
- Distal locking, especially in obese patients, can take patience and precise imaging.
These are not faults of the nail, they’re human challenges, but knowing them upfront helps surgeons and surgical teams avoid frustration.
Final Thoughts
The Intertan femoral nail has managed to establish itself not as a flashy trend but as a practical, dependable option for proximal femoral fractures. A design that combines stability with controlled compression translates not only into radiological success but also into better lives for patients who go from a fractured hip to walking again.
In orthopedics, that’s the real measure of success. Numbers and graphs matter, but seeing a patient mobilize with confidence, especially an elderly person who might otherwise face loss of independence, remains the ultimate proof that the device has earned its place.
Siora Surgicals Pvt Ltd. is a trusted name in the orthopedic implant manufacturing industry. The company fabricates CE and ISO 13485 certified trauma implants in its state-of-the-art manufacturing facility. Siora has a huge distributor base in over 50 countries. The company is also looking for orthopedic distributors in the USA to expand its international market reach.
