Your patients can enjoy life after hip fracture. Based on data from more than two-dozen published studies, the TRIGEN INTERTAN Intertrochanteric Antegrade Nail allows femur (hip) fracture patients to experience: TRIGEN INTERTAN Claims Brochure. The TRIGEN™ INTERTAN nail was designed as a trochanteric portal intramedullary nail especially shaped for fractures of the proximal femur. The. INTERTAN. The purpose of this study is to compare the Trigen InterTAN Intramedullary nail to Sliding Hip Screws in AO/OTA A1 and A2 intertrochanteric.


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The trapezoidal shape of the nail places more material at the lateral side of the implant where tensile forces are typically the strongest. In addition, the nail's trapezoidal profile trigen intertan provides enhanced anatomical fit and added rotational stability in the proximal femoral metaphysis similar trigen intertan that offered by conventional hip stems.

Trochanteric intramedullary nail - TRIGEN™ INTERTAN - Smith & Nephew

What is an Integrated Interlocking Screw configuration and how will it help my patients? The integrated interlocking screws of the INTERTAN system increase stability and resistance to both intra and post-operative fracture rotation about the implant by providing two points of fixation within the femoral neck and head.

This directly reduces rotational instability and eliminates the possibility of implant failure trigen intertan to Z-Effect. The INTERTAN system incorporates the best aspects of both devices by providing both single and dual integrated lag screws for the treatment of most major fracture patterns.

Trigen intertan is an unfortunate by-product of most intramedually nails that utilize two screws placed up into the femoral neck and head.

Typically, the superior screw is of smaller diameter than the inferior and bears a disproportionate amount of load during weight bearing. Excessive varus forces placed on the smaller screw at the lateral cortex cause it to toggle and either back out or migrate through the femoral head into the acetabulum.

The larger inferior screw is neither keyed in rotation nor locked in place, and it too will either back out or migrate medially.

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The resultant Z-Effect where the two screws move in opposite directions is one mode of failure for the conventional two screw reconstruction device. The INTERTAN nail turns that construct upside down and integrates the two screws so that they act as one device to bear all load, enact all compression and prevent excessive medial or lateral migration thus negating the Z-Effect.

Why do I ream with a 16mm channel reamer and the nail size is larger? Upon its initial insertion into the proximal femur, the INTERTAN nail exerts a small amount of press-fit within the canal by virtue of its trapezoidal cross-section. Once the correct degree of femoral neck anteversion has been determined, the trigen intertan can then be impacted into the proximal femoral metaphysis acting essentially as a broach to further enhance the initial press-fit.

The 17mm reamer is available to accommodate those instances when dense bone is encountered such that it precludes that initial press-fit.

TRIGEN INTERTAN Intertrochanteric Antegrade Nail | Smith & Nephew - Corporate

Why does the short nail have a clothespin distal tip? The clothespin distal tip of the INTERTAN short nail reduces the overall cross-sectional stiffness of the implant to minimize the risk of iatrogenic trigen intertan during insertion, to ease the actual process of nail insertion and to offer enhanced rotational stability within the proximal femoral canal.

This has the advantage of lessening point stresses about the distal tip of the nail and reducing the possibility of fracture due to a stress riser at that location.

If I only use the single subtrochanteric lag screw option does that create a stress riser at the empty inferior hole in the nail?

This is the same trigen intertan used in the testing of femoral stems for total joint replacement. This is representative of approximately six months implantation time at which fracture union should have occurred.


Our mechanical testing data reveals no significant stress riser occurring at that point. I have been using a single screw IM device for the last 20 years and have yet to have one cut out.

Do I have to use the integrated screws? Our designing surgeons feel that rotational instability is a major contributing factor to that failure rate and propose the INTERTAN nail as the solution to this dilemma.

trigen intertan

The problem lies in the fact that even implants that are keyed to prevent rotation can still experience rotation of the fragments about the axis of the lag screw.

Placement of a secondary point of fixation into the femoral neck and head reduces the chances of trigen intertan but adds the secondary concern of Z-Effect. Mechanical testing of the two screw construct was stopped atcycles with no evidence of implant cut out, further reinforcing the INTERTAN nail philosophy.

Excessively lateral nail insertion can cause damage to the abductor muscle group, the effects of which are not entirely clear. Recent literature JOT Vol.

They must be examined relative to the location of the offset, the AP bow of the nail and the trigen intertan of the nail entry point in both the AP and LM planes in order to get a complete picture.