Abstract
OBJECTIVE: To compare the clinical effects and safety of the proximal femur bionic nail (PFBN) with those of proximal femoral nail anti-rotation (PFNA) and InterTAN for the treatment of intertrochanteric femoral fracture (IFF). METHODS: Studies comparing the clinical efficacy of PFBN with that of PFNA and InterTAN in the treatment of IFF published before 16 December 2025 in the PubMed, Embase, Web of Science, Cochrane, CNKI, Wanfang, and VIP databases were retrieved. After the research data were extracted, Review Manager 5.4 (RevMan 5.4 ) was used for data analysis. RESULTS: A total of 15 studies involving 990 patients were included. The meta-analysis results indicated that the PFBN group had advantages over the control group in terms of the postoperative partial and full weight-bearing time, fracture healing time, fracture reduction quality, hospital stay, postoperative Harris score, intraoperative fluoroscopy time and postoperative complication rate (partial weight-bearing time: standardized mean difference (SMD) = -3.49, 95% confidence interval (CI) [-4.47 to -2.52], P < 0.00001; full weight-bearing time: SMD = -1.78, 95% CI [-2.86 to -0.70], P = 0.001; fracture healing time: SMD = -0.61, 95% CI -[0.86 to -0.37], P < 0.00001; fracture reduction quality: relative risk (RR) = 1.07, 95% CI [1.01∼1.13], P = 0.02; hospital stay: SMD = -0.44, 95% CI [-0.81 to -0.08], P = 0.02; postoperative complication rate: RR = 0.36, 95% CI [0.22∼0.59], P < 0.0001; postoperative Harris score: SMD = 0.32, 95% CI [0.04∼0.60], P = 0.02; intraoperative fluoroscopy time: SMD = 0.76, 95% CI [0.10∼1.42], P = 0.02). There was no significant difference between the two groups in terms of intraoperative blood loss, operation duration, postoperative hip range of motion, postoperative VAS score, or incision length (intraoperative blood loss: SMD = -0.30, 95% CI [-0.81∼0.21], P = 0.25; operation duration: SMD = 0.41, 95% CI [-0.03∼0.85], P = 0.07; postoperative flexion and extension motion: SMD = 0.28, 95% CI [-0.18∼0.73], P = 0.23; postoperative rotational motion: SMD = 0.20, 95% CI [-0.25∼0.66], P = 0.38; incision length: SMD = 0.23, 95% CI [-0.44∼0.89], P = 0.50; postoperative VAS score: SMD = -0.29, 95% CI [-0.82∼0.23], P = 0.27). CONCLUSION: For the treatment of IFF , the PFBN is more effective and has a lower risk than the PFNA and InterTAN.