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Background <p>This study aimed to compare the efficacy of the proximal femoral bionic nail (PFBN), proximal femoral nail antirotation (PFNA), and InterTan in the treatment of intertrochanteric fractures.</p> Methods <p>This network meta-analysis was conducted in accordance with the PRISMA 2020 statement and was registered in PROSPERO (CRD420216376949). PubMed, Embase, and Web of Science Core Collection were searched from inception to February 2026. Meta-analysis was performed using Stata 18.0 and R 4.6.0.</p> Results <p>A total of 29 studies involving 3173 patients were included, divided into three groups: PFNA, InterTan, and PFBN. There was no significant difference in surgical time or 12-month Harris score among the three surgeries in pairwise comparisons (95% CI crossing 0). PFBN was significantly better than PFNA in terms of blood loss (MD = − 21.60). Regarding complications, InterTan versus PFNA (RR = 0.31), PFBN versus PFNA (RR = 1.35), and PFBN versus InterTan (RR = 4.33) showed that InterTan differed significantly from PFNA and PFBN. In terms of weight-bearing time, InterTan versus PFNA (MD = − 6.52) and PFBN versus InterTan (MD = 7.81) showed significant differences, with InterTan having the shortest and PFBN the longest weight-bearing time. For fracture healing time, InterTan versus PFNA (MD = − 1.25) and PFBN versus InterTan (MD = 1.76) were significant, but their robustness was poor, and the quality of evidence was low. Meta-regression analysis with age (≥ 75 years) as a covariate showed that different surgeries had a significant differences on complications (OR: 0.41; I² = 88.8%; <i>p</i> = 0.000), weight-bearing time (Pooled mean = 8.15; I² = 99.7%; <i>p</i> = 0.000), fracture healing time (Pooled mean = 14.86; I² = 99.5%; <i>p</i> = 0.000), and 12-month Harris score (Pooled mean = 81.89; I² = 95.5%; <i>p</i> = 0.000). Moreover, significant interaction between different surgical methods and age groups(χ² = 12.70, df = 2, P = 0.0017).</p> Conclusion <p>InterTan was significantly superior to PFNA and PFBN in terms of weight-bearing time and complication risk.</p> Trial registration <p>CRD420216376949</p>

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Comparative therapeutic effects of the proximal femoral bionic nail (PFBN), PFNA, and InterTan for intertrochanteric fractures: a systematic review and network meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月1日

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  • Kai Zou,
  • Nianyu Li,
  • Rigao Chen,
  • Xiaohong Fan

摘要

Background

This study aimed to compare the efficacy of the proximal femoral bionic nail (PFBN), proximal femoral nail antirotation (PFNA), and InterTan in the treatment of intertrochanteric fractures.

Methods

This network meta-analysis was conducted in accordance with the PRISMA 2020 statement and was registered in PROSPERO (CRD420216376949). PubMed, Embase, and Web of Science Core Collection were searched from inception to February 2026. Meta-analysis was performed using Stata 18.0 and R 4.6.0.

Results

A total of 29 studies involving 3173 patients were included, divided into three groups: PFNA, InterTan, and PFBN. There was no significant difference in surgical time or 12-month Harris score among the three surgeries in pairwise comparisons (95% CI crossing 0). PFBN was significantly better than PFNA in terms of blood loss (MD = − 21.60). Regarding complications, InterTan versus PFNA (RR = 0.31), PFBN versus PFNA (RR = 1.35), and PFBN versus InterTan (RR = 4.33) showed that InterTan differed significantly from PFNA and PFBN. In terms of weight-bearing time, InterTan versus PFNA (MD = − 6.52) and PFBN versus InterTan (MD = 7.81) showed significant differences, with InterTan having the shortest and PFBN the longest weight-bearing time. For fracture healing time, InterTan versus PFNA (MD = − 1.25) and PFBN versus InterTan (MD = 1.76) were significant, but their robustness was poor, and the quality of evidence was low. Meta-regression analysis with age (≥ 75 years) as a covariate showed that different surgeries had a significant differences on complications (OR: 0.41; I² = 88.8%; p = 0.000), weight-bearing time (Pooled mean = 8.15; I² = 99.7%; p = 0.000), fracture healing time (Pooled mean = 14.86; I² = 99.5%; p = 0.000), and 12-month Harris score (Pooled mean = 81.89; I² = 95.5%; p = 0.000). Moreover, significant interaction between different surgical methods and age groups(χ² = 12.70, df = 2, P = 0.0017).

Conclusion

InterTan was significantly superior to PFNA and PFBN in terms of weight-bearing time and complication risk.

Trial registration

CRD420216376949