Abstract
Abstract
Objective
To systematically assess the efficacy and safety of the proximal femoral bionic nail (PFBN) compared with the InterTAN nail in the management of intertrochanteric femoral fractures (IFFs) among elderly individuals.
Methods
Eligibility criteria (inclusion and exclusion) were established in accordance with the PICOS framework. Relevant clinical studies were systematically retrieved from both Chinese (CNKI, VIP, and Wanfang Data) and English databases (PubMed, Embase, Web of Science, the Cochrane Library) with a search cutoff date of October 31, 2025. The Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool was employed to appraise methodological quality of the included literature. Meta-analyses of outcome measures, including intraoperative duration, intraoperative haemorrhage, length of hospital stay, postoperative weight-bearing duration, Harris Hip Score (HHS), and internal fixation-related complications, were conducted using RevMan 5.3 and Stata 15 software.
Results
Six relevant studies were finally enrolled in the present analysis, consisting of 2 prospective cohort studies and 4 retrospective cohort studies, with a total of 683 participants. Among all cases, 334 patients were allocated to the PFBN group and the remaining 349 cases received InterTAN nail fixation. Meta-analysis outcomes demonstrated no significant inter-group differences in intraoperative blood loss (
P
= 0.17), postoperative weight-bearing time (
P
= 0.47) and Harris Hip Score (HHS) (
P
= 0.11). When compared with the InterTAN nail system, the PFBN group presented a shorter hospital stay (
P
= 0.04) and a decreased rate of internal fixation-related complications (
P
= 0.01), whereas the PFBN group had a longer operative time (
P
= 0.03). Sensitivity analysis further confirmed the good overall stability and reliability of the pooled outcomes in this meta-analysis.
Conclusion
Based on the limited evidence from current non-randomized studies, PFBN exhibits potential benefits in shortening hospital duration and reducing the risk of internal fixation-related complications among elderly patients with intertrochanteric femoral fractures. Meanwhile, this implant yields equivalent effects to the InterTAN nail with regard to functional recovery. Given the observational design of all included trials and substantial heterogeneity in several outcomes, these findings warrant cautious interpretation.